PHARMACY PROVIDERS, PLEASE
If you are unsure about the coverage
of a drug product, please contact the PBM help desk at 1-800-648-0790.
Please file adjustments for claims
that may have been incorrectly paid. Only those products of the manufacturers
which participate in the Federal Rebate Program will be covered by the Medicaid
program. Participation may be verified in Appendix C, available at
Should you have any questions
regarding any of the following messages, please contact Molina Medicaid
Solutions at (800) 473-2783 or (225) 924-5040.
Attention Louisiana Fee for Service (FFS) Medicaid Providers:
On December 27, 2018, Fee for Service (FFS) Medicaid implemented clinical pre-authorization requirements at Point of Sale (POS) for Growth Hormones, Cytokine and Cell-Adhesion (CAM) Molecule Antagonists, Lomitapide (Juxtapid®), Mipomersen (Kynamro®), Alirocumab (Praluent®), and Evolocumab (Repatha®). Please refer to www.lamedicaid.com for more information.
Attention Louisiana Medicaid Providers:
Effective January 1, 2019, Fee for Service (FFS) Medicaid and Managed Care Organizations (MCOs) will implement a diagnosis code exemption for sickle cell crisis for opioid prescriptions. Please refer to www.lamedicaid.com for more information.