The Division of TennCare issued Provider_Notice_Contraceptives_11.05.24.pdf. Effective January 1, 2025, in response to the amended Tennessee Code Annotated (TCA), Title 56, Chapter 7, Part 23 (Public Chapter No. 732), TennCare and CoverKids members are eligible to receive up to a 12-month supply of self-administered hormonal contraceptives (e.g., oral, topical and vaginal) in a single dispensing. A smaller quantity may be provided if requested by the member or if specified by the healthcare provider.
This legislation does not apply to contraceptives administered by a healthcare provider, such as intrauterine devices, implants and injectable contraceptives.
For TennCare members, please refer to the TennCare-PDL (Preferred Drug List) (optumrx.com) for a list of preferred contraceptives. Non-preferred contraceptives still require prior authorization (PA) approval before a single 12-month supply can be dispensed.
For CoverKids members, please refer to CoverKids Select Standard Formulary (optumrx.com) for a list of covered contraceptives.
All standard point-of-sale edits (e.g., quantity limits, refill too soon, duplicate therapy, etc.) associated with contraceptives will remain in place.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.