LETTER TO PROVIDERS

May 24, 2002

Dear  Prescribing Practitioners and Pharmacy Providers:

 In January 2002 you were notified that the Department of Health and Hospitals (DHH) planned to establish a pharmacy prior authorization (PA) process with a preferred drug list (PDL) for certain drugs covered under the Medicaid Pharmacy Benefits Program.    Workshops on the new prior authorization process were held in February and March.  On May 22, 2002 the Louisiana Legislature’s Joint Committee on Health and Welfare approved the Department to implement this process effective June 10, 2002.

With the implementation of the PA process, drugs will be considered “preferred” or “non-preferred”.  Non-preferred drugs will require PA as a condition for payment by the program.  The PDL is established by selected therapeutic classes for those drugs that PA is not required.  Drugs in these therapeutic classes that are not included on the PDL shall require PA and prescribing practitioners must obtain PA by contacting the University of Louisiana at Monroe (ULM), College of Pharmacy Prior Authorization Unit.  Information on the process is included in the attached documents.  Providers will be notified of drugs selected for placement on the PDL by selected therapeutic classes prior to the effective dates.

Implementation of the PA process will be by a phased-in approach starting with the Proton Pump Inhibitors and the COX2 Inhibitors therapeutic classes on June 10, 2002.  The following material is attached to assist you in the new process:

1.                  A listing of drugs in the first group of therapeutic classes to be included in the PA process with effective implementation dates.

2.                  A process and procedures document, “Louisiana Medicaid Pharmacy Benefits Management Prior Authorization Program”.

3.                  “Request For Prescription Prior Authorization” Form.

Information on the Prior Authorization process, including the PDL, is also available on the Louisiana Medicaid website (www.lamedicaid.com). This website will be updated when changes (additions or deletions) are made to the PDL.  PDL changes will also be in a message on the provider’s remittance advice.

Thank you for your cooperation as we implement this new process.  We appreciate your participation in the Medicaid program

Sincerely,

Ben A. Bearden

Director

BAB/mjt

Attachments (3)  

The above letter and the Preferred Drug List are also available in PDF format on the Downloadable Forms and Files page.