Pharmacy Updates

Please see links below for Synagis coverage for July 2021-October 2021:

Louisiana Medicaid Pharmacy Palivizumab (Synagis®) Coverage – Effective July 15, 2021
https://ldh.la.gov/assets/HealthyLa/PDL/12.2.2020/2/Palivizumab.Criteria.11182020.pdf
https://ldh.la.gov/assets/HealthyLa/PDL/6.12.2020.5/Palivizumab.Request.Form.with.Cover.Sheet.July.2020.pdf

January 1, 2021 Implementations

Louisiana Medicaid Pharmacy Point of Sale Diagnosis Code Requirements for Select Drugs – Effective January 1, 2021
Louisiana Medicaid Pharmacy Point of Sale Prior Use Edit for Cariprazine (Vraylar®) and Lurasidone (Latuda®) – Effective January 1, 2021
Louisiana Medicaid Pharmacy Point of Sale Clinical Updates and Therapeutic Duplication for Agalsidase Beta (Fabrazyme®) and Migalastat (Galafold®) – January 1, 2021
Louisiana Medicaid Pharmacy Point of Sale Clinical Authorization for Select Drugs – Effective January 1, 2021
Louisiana Medicaid Pharmacy COVID-19 Vaccine Coverage – Effective December 23, 2020
Louisiana Medicaid Pharmacy Point of Sale (POS) Quantity Limit Edits – Effective January 1, 2021
Pharmacy Providers RxPA Information Letter – Effective January 1, 2021

Hurricane Ida Updates

August 2021 Hurricane Ida Information for Medicaid Pharmacy Updated Informational Bulletin posted here: https://ldh.la.gov/assets/docs/BayouHealth/Informational_Bulletins/2021/21-17/IB21-17_revised_9.3.21.pdf Follow this link for other resources including FAQs for...

Hurricane Ida Provider Notice Posted

https://www.lamedicaid.com/provweb1/Pharmacy/HurricaneIda_ProviderMemoforMedicaidPharmacy_08282021.pdf

Provider Notices for September 1st Implementations

Louisiana Medicaid Pharmacy Diagnosis Code Requirement for Ivermectin (Stromectol®) - Effective September 1, 2021 Louisiana Medicaid Pharmacy COVID-19 Vaccine Coverage Updates - Effective September 1, 2021

Pharmacy Facts 8-20-21

August 20, 2021 COVID-19 Update In response to the COVID-19 pandemic and Public Health Emergency (PHE), and more recently the COVID-19 delta variant spread, the Louisiana Medicaid pharmacy program has updated coverage for COVID-19 vaccines. Currently, the Pfizer,...

July Policy Memos 6-30-21

Louisiana Medicaid Pharmacy Point of Sale Diagnosis Code Requirements for Select Drugs - Effective July 1, 2021 Louisiana Medicaid Pharmacy Point of Sale Quantity Limit for Dulaglutide (Trulicity®) - Effective July 1, 2021 Louisiana Medicaid Pharmacy Point of Sale...

Pharmacy Facts 6-1-21

June 1, 2021 Delivery Model Feedback The Louisiana Department of Health (LDH) continues its commitment to transforming its Medicaid managed care program to provide better care and better health for its members. As part of this goal, LDH is reviewing the current...

Pharmacy Facts 5-25-21

May 25, 2021 Fee for Service (FFS) Point of Sale (POS) Downtime This is to alert all Louisiana Medicaid pharmacies that the FFS POS mainframe system will have downtime today, May 25, 2021, starting at 6 p.m. for approximately one hour. Claims should be submitted when...

Program Updates from Louisiana Medicaid

March 25, 2020 | COVID-19 Update As a precaution with the current COVID-19 pandemic, the Louisiana Department of Health (LDH) intends to take measures to minimize public exposure. A few pharmacy edits will be revised to encourage recipients to get all...

Pharmacy Facts 1-3-2020

January 3, 2020 It has just come to Louisiana Medicaids attention that correspondence went to pharmacy providers regarding Point of Sale Certification. This recertification information is used internally by pharmacy staff to ensure we have appropriate contact...

Copay Letters Posted

Provider Copay Notice Louisiana Medicaid Fee for Service (FFS) and Managed Care Organizations (MCOs) Assessment of Updated Pharmacy Copayments - Effective January 1, 2020 Recipient Copay Notice Louisiana Medicaid Pharmacy Copayments - Recipient Notice