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TennCare to remove 5-prescription-per-month generic limit for adults; committee advances rule
Summary
TennCare proposed removing a 5-prescription-per-month limit on generic drugs for enrollees 21 and older and clarified brand-name limits remain; the committee advanced the permanent rule with a positive recommendation.
TennCare counsel Amanda Petri told the committee the permanent rules would remove a five-prescription-per-month limit on generic drugs for TennCare enrollees aged 21 and older, aligning permanent rules to mirror emergency rules filed earlier in the year. She said the permanent rules are set to take effect Jan. 26, 2026 and that the department held a public hearing in August with no comments.
Representative Clemons asked whether the change replaced the 5-limit with a 2-limit; Petri clarified the two-prescription restriction applies to brand-name drugs and was not introduced as a replacement for the generic limit. The committee recorded a senate roll call with seven ayes and one no; the house voice vote recorded the ayes and the rule was given a positive recommendation to move forward.
