Pharmacy
The Louisiana Department of Health pharmacy services are included as a benefit in managed care. Pharmacy services remain in legacy Medicaid for recipients not enrolled in managed care. Pharmacy provider relations support for legacy Medicaid is handled by the Medicaid fiscal intermediary, Gainwell Technologies. For questions or concerns please email LDH pharmacy staff at PharmacyMedicaid@la.gov.
Louisiana Medicaid Single Preferred Drug List (PDL)
- Louisiana Medicaid Single PDL – Fee for Service and Managed Care Organizations
- Archived PDLs
- Diabetic Supplies PDL
- Drug File Search Tool
Pharmacy Resources
- Prime Therapeutics MCO PBM Portal
- Act 292 of the 2022 Regular Legislative Session Council on Medicaid Pharmacy Reimbursement
- Submit Remittance Advice (RA) Request
- Louisiana Uniform Prescription Drug Prior Authorization (PA) Form and Fax Coversheet
- ICD-10-CM Diagnosis Code Policy Chart
- Maintenance Medications - Quarterly
- MEVS Help Guide
- Medicaid Pharmaceutical & Therapeutics Committee
- Pharmacy Provider Notices
- Naloxone Standing Order
Pharmacy Facts
Contacts
Questions can be directed by plan as follows:
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Aetna Better Health |
AmeriHealth Caritas |
Healthy Blue |
Humana Healthy Horizons in Louisiana |
Louisiana Healthcare Connections |
UnitedHealthcare Community Plan |
General Provider Issues-call Provider Relations |
1-855-242-0802 |
1-888-756-0004 |
1-844-521-6942 |
1-800-448-3810 |
1-866-595-8133 |
1-866-675-1607 |
Member with Issues – call Member Services |
1-855-242-0802 |
1-888-756-0004 |
1-844-521-6941 |
1-800-448-3810 |
1-866-595-8133 |
1-866-675-1607 |
Claims/Billing Issues – Call Pharmacy Helpdesk |
1-800-424-1664 for all MCOs. |
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Pharmacy Contracting Issues |
1-800-424-1664 for all MCOs. |
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Pharmacy Billing Information (DOS prior to 10/28/2023) |
BIN: 610591 |
BIN: 019595 |
BIN: 020107 |
BIN: 610514 |
BIN: 004336 |
BIN: 610494 |
Pharmacy Billing Information (DOS 10/28/23 forward) |
BIN: 025986
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Medical PA requests/ inquiries for provider- administered drugs |
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Phone:
Fax: |
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Fee For Service
- General Provider Issues - Call Provider Relations - 1-800-473-2783
- Pharmacy Contracting Issues - Call Gainwell Technologies Provider Enrollment - 1-225-216-6370
- Pharmacy Credentialing - Call Gainwell Technologies Provider Enrollment - 1-225-216-6370
- Pharmacy Claims/Billing Issues - Call POS Help Desk - 1-800-648-0790 or 225-216-6381
- Pharmacy Billing Information - Call POS Help Desk - 1-800-648-0790 or 225-216-6381
- BIN: 610514
- PCN: LOUIPROD
- Group: n/a
- Provider Enrollment Portal Issue - Call: 1-833-641-2140 or email: LouisianaProvEnroll@gainwelltechnologies.com
Any other pharmacy-related questions can be directed to the Medicaid Pharmacy Program at 1-800-437-9101.
Providers can also submit questions by email to healthy@la.gov, and the appropriate staff will address any issues or concerns. Staff are typically able to respond within one business day.
Pharmacists and prescribing providers are strongly encouraged to review Informational Bulletins pertaining to the pharmacy integration.
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To subscribe to email blasts for Medicaid Pharmacy provider notices, Pharmacy Facts or other announcements, email PharmacyMedicaid@la.gov.
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