Louisiana Healthcare Connections Policies and Procedures Updates
Date: 11/12/25
Louisiana Healthcare Connections is sharing with providers the below policies and procedures that were developed and/or revised; posted for public comment and approved by LDH in accordance with La. R.S. 46:460.54. Non-material revisions do not require LDH approvals.
Please share this notice with other members of your practice and office staff as necessary.
These guidelines will be implemented 30 days from the date of this notice and will be posted on our Clinical & Payment Policies page.
Policy & Procedure # | Policy & Procedure Title | New, material revisions, non-material revisions |
|---|---|---|
LA.PHAR.11 | Burosumab-twza (Crysvita) | Material |
LA.PHAR.146 | Deferoxamine (Desferal) | Material |
LA.PHAR.184 | Aflibercept (Eylea, Eylea HD, Opuviz, Yesafili, Ahzantive, Enzeevu, Pavblu) | Material |
LA.PHAR.186 | Ranibizumab (Byooviz, Cimerli, Lucentis, Susvimo) | Material |
LA.PHAR.384 | Lutetium Lu 177 Dotatate (Lutathera) | Material |
LA.PHAR.433 | Polatuzumab Vedotin-piiq (Polivy) | Material |
LA.PHAR.495 | Mitomycin for Pyelocalyceal Solution (Jelmyto) | Material |
LA.PHAR.524 | Pegcetacoplan (Empaveli, Syfovre) | Material |
LA.PHAR.634 | Epcoritamab-bysp (Epkinly) | Material |
LA.PHAR.636 | Glofitamab-gxbm (Columvi) | Material |
LA.PHAR.733 | Telisotuzumab Vedotin-tllv (Emrelis) | New |