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Private TPL and Medicare Advantage Plan Update Request Change (IB 25-19)

Date: 08/01/25

Louisiana Healthcare Connections is sharing a publication for providers regarding Private TPL and Medicare Advantage Plan Update Request Change (IB 25-19). 

Effective August 1, 2025, the process for updating Third Party Liability (TPL) for Medicaid members will change to align with Act 293 of the 2025 regular legislative session. Third Party Liability Updates for Managed Care Members For Medicaid members enrolled in a managed care organization (MCO), providers must contact the member’s specific MCO to add or update TPL information. Contact information for each MCO is provided below.

Louisiana Healthcare Connections contact information is:

  • Email: LHCC_MemberAdvocate@CENTENE.COM – general TPL update requests
  • Fax: 1-844-316-0290 – urgent TPL requests (pharmacy-related or access immediate care) 
  • Phone: 1-866-595-8133 – urgent TPL requests (pharmacy-related or access immediate care) 

Third Party Liability Updates for Fee-for-Service Beneficiaries

For beneficiaries receiving fee-for-service Medicaid, please contact HMS to add or update TPL records.

HMS Contact Information:

  • Fax: (877) 204-1325  Email: latpr@gainwelltechnologies.com
  • Urgent TPL Requests for Fee For Service: latprescalations@gainwelltechnologies.com
  • Phone: (877) 204-1324 
  • Hours: Monday through Friday, 8 a.m. – 5 p.m. (excluding Louisiana state holidays) 

Traditional Medicare Updates and TPL Escalations

All TPL update requests for traditional Medicare should be submitted to the Louisiana Department of Health (LDH) TPL Unit via email, fax or phone. Escalation requests may also be sent to this unit in the following situations:

  • More than 5 business days have passed since the initial request, and the change is not reflected in the Medicaid Eligibility Verification System (MEVS).
  • Urgent pharmacy requests that have not been resolved in 4 business hours.
  • Emergency updates needed to ensure immediate medical care access. 

LDH TPL Unit Contact Information

  • Email: tpl.inquiries@la.gov
  • Fax: (225) 389-2709
  • Phone: (225) 342-4510
  • Hours: Monday through Friday, 8 a.m. – 4:30 p.m. (excluding Louisiana state holidays) 

Urgent Private TPL and Urgent Medicare Advantage Plan Update Requests

Urgent TPL requests should be submitted as follows:

  • Managed care members: Contact the member’s MCO.
  • Fee-for-service beneficiaries (Legacy Medicaid): Contact HMS using the information above.

Urgent TPL requests are defined as the inability of a member to have a prescription filled or the inability of a member to access immediate care because of incorrect third-party insurance coverage.

Private TPL and Medicare Advantage Plan Update Request Change Forms can be found here: Recipient_Insurance_Update.pdf.

The Traditional Medicare Update Form can be found here: TraditionalMedicare.pdf.

Please send any questions regarding TPL to tpl.inquiries@la.gov.

Providers can review the complete  IB 25-19 for additional details.