Important Pharmacy Claims Processing Change, Effective October 1, 2025
Date: 08/22/25
Effective October 1, 2025, Louisiana Healthcare Connections will transition to Express Scripts, Inc. as our new pharmacy benefit manager (PBM) for managed care members.
Through September 30, 2025
- Pharmacies should continue using Prime Therapeutics (RxBIN 25986).
- Providers should continue submitting prior authorization (PA) requests to Prime Therapeutics.
Beginning October 1, 2025
- Pharmacies should use Express Scripts, Inc. (RxBIN 003858/ PCN MA/RxGroup 2ENA). Pharmacists can call Express Scripts' dedicated help line, 1-833-750-4451.
- Providers can submit new PA requests by calling Louisiana Healthcare Connections at 1-866-595-8133.
All existing prior authorizations will be transferred to Express Scripts and will remain valid. No additional action is needed from providers or members.
New ID Cards for Members
In the coming weeks, all affected Louisiana Healthcare Connections members will receive updated ID cards with the new PBM information. During the transition period, members may present ID cards with either the current or new PBM details, but pharmacies should use the correct PBM to process prescriptions.
We are here to help.
The Louisiana Department of Health, the Medicaid health plans, and all involved PBMs are working together to ensure a smooth transition for members, providers, and pharmacies.
Questions? Please contact your Provider Relations Representative. If your patients (our members) have questions about this change, please direct them to Member Services at 1-866-595-8133.
Note: This change does not affect members enrolled in Fee-for-Service Medicaid. Those covered under the fee-for-service program will continue to use their current pharmacy benefit manager.