RA Messages for November 6, 2012


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 www.lamedicaid.com

Should you have any questions regarding any of the following messages, please contact Molina Medicaid Solutions at (800) 473-2783 or (225) 924-5040.


Effective immediately, Louisiana Medicaid will reimburse for Brand Name drugs at a Brand reimbursement when the Brand drug is on the PDL and the generic drug requires PA. To be reimbursed at a Brand, enter a value of �9,� which is Substitution Allowed by Prescriber but Plan Requests Brand; in the NCPDP field #408-D8. When �9� is entered in NCPDP field #408-D8, it will not be necessary for �Brand Medically Necessary� to be handwritten on the prescription by the prescriber. Please call the Pharmacy POS Helpdesk at 1-800-648-0790 for questions.


Louisiana Medicaid has updated RXPA forms. These forms are used when requesting Prior Authorization (PA) for drugs not on the Preferred Drug List (PDL) and forms used for reconsideration of a PA. These updated forms can be found at http://www.lamedicaid.com/provweb1/Pharmacy/rxpa/rxpaindex.htm. Please call the Pharmacy POS Helpdesk at 1-800-648-0790 for questions.