# 12 Va. Admin. Code § 30-50-75: 12VAC30-50-75. Requirements relating to payment for covered outpatient drugs for the medically needy

> Virginia · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_75

## Section

- **Citation:** 12 Va. Admin. Code § 30-50-75
- **Heading:** 12VAC30-50-75. Requirements relating to payment for covered outpatient drugs for the medically needy
- **Jurisdiction:** Virginia
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Virginia Administrative Code / Title 12 Health / Agency 30 Department of Medical Assistance Services / Chapter 50 / 12VAC30-50-75

## Text

A. Effective January 1, 2006, the Medicaid agency will not cover any Part D drug for full-benefit dual eligible individuals who are entitled to receive Medicare benefits under Part A or Part B.
The Medicaid agency provides coverage for the following excluded or otherwise restricted drugs or classes of drugs, or their medical uses to all Medicaid recipients, including full benefit dual eligible beneficiaries under the Medicare Prescription Drug Benefit Part D. The following excluded drugs are covered:
1. Agents when used for anorexia, weight loss, or weight gain (see specific drug categories in subsection B of this section);
2. Agents when used for the symptomatic relief of cough and colds (see specific drug categories in subsection B of this section);
3. Prescription vitamins and mineral products, except prenatal vitamins and fluoride (see specific drug categories in subsection B of this section); and
4. Nonprescription drugs (see specific drug categories in subsection B of this section).
B. Coverage of specific categories of excluded drugs will be in accordance with existing Medicaid policy as described in 12VAC30-50-520 .

## Nearby sections

- [12 Va. Admin. Code § 30-50-10 12VAC30-50-10. Services provided to the categorically needy with limitations](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_10.md)
- [12 Va. Admin. Code § 30-50-20 12VAC30-50-20. Services provided to the categorically needy without limitation](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_20.md)
- [12 Va. Admin. Code § 30-50-30 12VAC30-50-30. Services not provided to the categorically needy](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_30.md)
- [12 Va. Admin. Code § 30-50-35 12VAC30-50-35. Requirements relating to payment for covered outpatient drugs for the categorically needy](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_35.md)
- [12 Va. Admin. Code § 30-50-40 12VAC30-50-40. Ambulatory services](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_40.md)
- [12 Va. Admin. Code § 30-50-50 12VAC30-50-50. Services provided to the medically needy with limitations](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_50.md)
- [12 Va. Admin. Code § 30-50-60 12VAC30-50-60. Services provided to all medically needy groups without limitations](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_60.md)
- [12 Va. Admin. Code § 30-50-70 12VAC30-50-70. Services or devices not provided to the medically needy](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_70.md)
- [12 Va. Admin. Code § 30-50-75 12VAC30-50-75. Requirements relating to payment for covered outpatient drugs for the medically needy](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_75.md)
- [12 Va. Admin. Code § 30-50-95 12VAC30-50-95. Reimbursement of services; in general](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_95.md)
- [12 Va. Admin. Code § 30-50-100 12VAC30-50-100. Inpatient hospital services provided at general acute care hospitals and freestanding psychiatric hospitals; enrolled providers](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_100.md)
- [12 Va. Admin. Code § 30-50-105 12VAC30-50-105. Inpatient hospital services provided at general acute care hospitals and freestanding psychiatric hospitals; nonenrolled providers (nonparticipating/out of state)](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_105.md)
- [12 Va. Admin. Code § 30-50-110 12VAC30-50-110. Outpatient hospital and rural health clinic services](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_110.md)
- [12 Va. Admin. Code § 30-50-120 12VAC30-50-120. Other laboratory and x-ray services](https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_120.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_VA_ADC_12_30_50_75. Check the current official text before relying on it. Not legal advice.