LETTER TO PHARMACISTS
RE: PDL # 06-01
Attached is the
complete, most current listing of drugs on the Medicaid Prior Authorization (PA)
Process' Preferred Drug List (PDL) "06-01." The listing includes preferred drugs and those drugs requiring prior
list will be effective April 1, 2006.
The PA process,
in accordance with the program's "Continuity of Care" policy, does not
impact original prescriptions (or refills) issued by a prescribing practitioner
prior to effective PA dates of drugs as they are added to the PA process as
long as they are within the 5 refills and 6-month program limits. An
educational alert will notify the pharmacist that prescriptions (and their
refills) will require a new prescription and prior authorization, if the
prescription life exceeds six months or the refill exceeds the 5 refill limit.
The educational alert will state, "NEW RX WILL REQUIRE PA AFTER (DATE)."
the Prior Authorization process, including the PDL and Prior Authorization
Request Form (copy is attached, Form RXPA01), 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. The program may also utilize the provider remittance advices to notify
providers of PDL changes that must be implemented in short time frames.
has received inquiries that drug products requiring PA are not reimbursable by
Medicaid. Medicaid does reimburse for drug products requiring prior
authorization when the prior authorization process is followed. Additionally, should a claim deny because a PA is required, you may want
to 1) verify that the PA was actually obtained and the dates of service for the
PA; 2) verify that the filling date on the claim is subsequent to the start date
of the PA. (Remember: PAs are not retroactive); and 3) call the POS help desk at 1-800-648-0790
for further assistance.
Thank you for your continued cooperation. We
appreciate your participation in the Medicaid Program.
The above letter and the Preferred Drug
also available in PDF format on the Downloadable
Forms and Files page.