Effective October 1, 2023, the Department of Health (LHD) is increasing the professional dispensing fee (PDF) $0.82 to $11.81 for local pharmacies only for all Medicaid Fee-for-Service (FFS) and Managed Care Organization (MCO)claims. The current PDF is $10.99.
Also in Louisiana, the Department of Health (LDH) Bureau of Health Services Financing’s Interim Medicaid Executive Director Kimberly Sullivan announced the new implementation date for the Single Pharmacy Benefits Manager (PBM) for Managed Care Organizations (MCOs) is now October 28, 2023. Magellan Medicaid Administration Inc. will serve as the single PBM processor for all six MCOs (Aetna, AmeriHealth Caritas, Healthy Blue, Humana Healthy Horizons, Louisiana Healthcare Connections and United Healthcare).
Also in Louisiana, the Board published five final rules in the September 20, 2023, edition of the Louisiana Register, with immediate effective dates.
- Regulatory Project 2023-03 – Pharmacy Benefit Managers
- Regulatory Project 2023-04 – Healthcare Workplace Violence Prevention
- Regulatory Project 2023-05 – Pharmacy Change of Ownership
- Regulatory Project 2023-06 – Staffing Ratios
- Regulatory Project 2023-08 – DATA-Waiver Registration Elimination
Finally in Louisiana, the Department of Health (LDH) Medicaid issued several documents detailing changes also effective October 1:
- Louisiana Medicaid Pharmacy Maintenance Medications Professional Dispensing Fee for Managed Care Organizations (MCOs) – Effective October 1, 2023
- Louisiana Medicaid Pharmacy Single Pharmacy Benefits Manager (PBM) for Medicaid Managed Care – Effective October 1, 2023
- Louisiana Medicaid Pharmacy Clotting Factor Products Update – Effective October 1, 2023
- Louisiana Medicaid Pharmacy Counseling for Vaccines – Effective October 1, 2023
For more information, contact NACDS’ Mary Staples at 817-442-1155.