The new Single Pharmacy Benefits Manager (PBM) for Medicaid Managed Care will start on October 1, 2023. Magellan Medicaid Administration (MMA) will process all Medicaid managed care organization (MCO) pharmacy claims.
- A new Department of Health (LDH (Louisiana Department of Health)) Pharmacy portal still under construction website will go live on October 1, 2023.
- Pharmacy processing information for all six Medicaid MCOs (Managed Care Organizations) starting October 1, 2023:
- BIN Number: 025986
- NCPDP (National Council for Prescription Drug Programs) Version/Release #: D.0
- Processor Control #: 1214172240
- Group ID: LAMCOPBM
- Magellan Rx Management Pharmacy Call Center is available 24 hours a day, seven days a week, 365 days a year.
- The Member and Pharmacy Help Desk Phone Number is 1-800-424-1664
- Pharmacy Prior Authorizations (PA) phone number: 1-800-424-1664
- Fax Number: 1-800-424-7402
- Electronic: Enter prescriber PA at www.covermymeds.com
- MRx encourages pharmacies to submit test claims prior to the transition during the testing window from August 28, 2023, through September 15, 2023. To participate, you will need to e-mail MRxPharmacyTesting@magellanhealth.com with your name, phone number, pharmacy National Provider Identifier, and Switch information to receive the testing packet.
Also in Louisiana, state elections will be held this fall. The Primary will be held on October 14, and the General election will be on November 18. Tim Temple (R) is now running unopposed for Insurance Commissioner now that political newcomer Rich Weaver, dropped out of that race.
Also in Louisiana, starting on October 1, LDH will reimburse pharmacies for glucose monitors and diabetics supplies, and add diabetic supplies to the Medicaid Single Preferred Drug List to have one list of preferred/non-preferred products. As of December 1, 2023, diabetic supplies will be limited to pharmacy claims only.
Also in Louisiana, the next scheduled meeting of the Council on Medicaid Pharmacy Reimbursement is on September 13.
Also in Louisiana, Kimberly Sullivan is the new Interim Executive Medicaid Director for the Louisiana Department of Health (LDH), replacing Tara LeBlanc.
Finally in Louisiana, LDH provided several updates for pharmacies.
- 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.