PHARMACY BENEFITS MANAGEMENT (PBM) PROGRAM

The PDL changes from the Aug. 13, 2008 P&T meeting will be implemented on November 1, 2008

Tamper-Resistant Prescription Pads Required October 1, 2008 08/29/08

Preferred Drug List/Prior Authorization List
(Update list from the August 13, 2008 P&T Committee Meeting - Effective November 1, 2008)

eCDI Information for Medicaid Prescribing Practitioners
Prescribing Provider File (PPN)
(Zip file)		 Listing of prescribing providers sorted by 
provider name.
Prescribing Provider File (PPN)
(Zip file)		 Listing of prescribing providers sorted by 
provider type.

RXPA

 Pharmacy Prior Authorization Program
Drug Appendices Drug lists identifying program pay status
DSM Program Disease State Management Program
Pharmacy Benefits Management Services, Chapter 37 - Updated November 01, 2008 Provider manual containing policies and procedures needed to receive reimbursement for covered services provided to eligible Louisiana Medicaid recipients.
Point of Sale (POS) User Guide User Manual for the Pharmacy Point of Sale Program. Revised November 01, 2008
POS Vendor Specs Document Vendor Specifications Document for the POS Adjudication System.
POS Vendor Specs Appendices Vendor Specifications Appendices for the POS Adjudication System.
Provider/Recipient Correspondence Letters and updates sent to pharmacy and prescribing providers and Medicaid recipients

The LMMIS  Pharmacy Benefits Management (PBM) Program has responsibility for the coordination of  all  Medicaid  pharmacy-related services.   Services include:

Other services available to pharmacy providers include:

The PA process is supported by the operations of the University of Louisiana at Monroe College of Pharmacy (ULM) Prior Approval  Desk.

For more information on specific components of the Pharmacy Benefits Program, click on the “bold faced” services noted above.