2019-14: Louisiana Medicaid single PDL to take effect May 1, 2019
Date: 02/27/19
Review the new single PDL to prepare your practice and your patients
Per the Louisiana Department of Health (LDH), Louisiana Medicaid has established a May 2019 timeframe for implementation of a single preferred drug list (PDL) across all managed care organizations (MCOs) and Medicaid fee-for-service. The goals of this implementation are to improve member experience, to improve provider experience and to promote better health outcomes. The single PDL will be updated biannually. To minimize disruption to you, your practice and your patients, please review the most current version of the single PDL on the LDH website (PDF).
Due to the single PDL implementation, Louisiana Healthcare Connections will no longer require Prior Authorization (PA) for certain medications that previously required approval, and will now require PA for certain medications that did not previously require approval. In addition, some classes of drugs will no longer be covered. These changes will take effect on May 1, 2019. If your patient is a member of Louisiana Healthcare Connections and you feel your patient should stay on a prescribed medication that now requires prior authorization, please request a PA. To request a PA, please call 1-888-929-3790 or fax your request to 1-866-399-0929. You can find the PA form at www.lahealth.cc/paform. We will work with you to make sure our members have the medications they need.
By reviewing claim data from the past six months, Envolve Pharmacy Solutions has determined which members processed a prescription for a drug that will require PA beginning on May 1, 2019. These members will be sent written notification of this change 60 days prior to the single PDL implementation. Members have been instructed to contact their healthcare provider if they have concerns about how this change may affect their care.
We value the care you provide to your patients – our members, and we hope that this information assists you in making informed decisions. If you have any questions about this implementation, please contact Provider Services at 1-866-595-8133.