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


Optometrists enrolled in Louisiana Medicaid are considered part of the Professional Services program. Optometrists who perform eye care services that are within their scope of practice will receive Medicaid reimbursement to the same extent, and according to the same standards, as physicians who perform the same eye care services.  


Effective with the Remittance Advice of April 26, 2011:

McKesson's 'ClaimCheck' product is routinely updated by McKesson Corporation based on changes made to the resources used, such as Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) coding guidelines, the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule database, and/or provider specialty society updates. The 'ClaimCheck' product's procedure code edits are guided by these widely accepted industry standards. These edit changes will affect claims processed beginning with the remittance advice of April 26, 2011 forward. Providers may notice some differences in claims editing that includes Pre/Post-op Days, Incidental Mutually Exclusive, Rebundling and Multiple Surgery Reductions. Providers should expect that some claims will continue to deny for the same error, but when applicable, claims may now pay or deny for a different reason. Providers will continue to be notified when these routine updates are made in the future. For questions related to this information, please contact Molina Provider Services at (800)-473-2783 or (225)-924-5040.