November 18 is the date for runoff election for those statewide and state legislative races. Chain pharmacies are closely watching State Rep. Barbara Frieberg (R) race in Baton Rouge, as she was our champion that fought for the immunizations bill that died in the last two hours of the legislative session that would have made the federal PREP (Public Readiness and Emergency Preparedness) Act efficiencies permanent. 

Also in Louisiana, if the Louisiana Legislature wants to prevent a district court from changing its congressional map, it has until January 15 to produce a new redistricting plan, the 5th Circuit Court of Appeals ruled on November 10. 

Also in Louisiana, the Board of Pharmacy’s quarterly meeting was on November 15 in Baton Rouge. 

Also in Louisiana, Medicaid announced that by the end of the year there will be a new Naloxone Standing Order signed by Dr. Shantel Hebert-Magee, the state’s new Medicaid Chief Medical Officer, once Dr. James Hussey retires. Pharmacies need to take note for 2024 billing purposes. 

Finally in Louisiana, the Single Pharmacy Benefits Manager (PBM) for Managed Care Organizations (MCO) managed by Magellan, was finally implemented on October 28. Magellan Medicaid Administration Inc. is now processing Medicaid MCO (managed care organization) pharmacy claims for all six MCOs (Managed Care Organizations) (Aetna Better Health, AmeriHealth Caritas, Healthy Blue, Humana Healthy Horizons, Louisiana Healthcare Connections and UnitedHealthcare Community Plan). The Magellan Medicaid Administration portal is live with helpful information.  

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Department of Health (LDH (Louisiana Department of Health)) Medicaid posted several new provider notices. 

• Louisiana Medicaid Pharmacy Diabetic Supplies on the Preferred Drug List (PDL) for Outpatient Pharmacy Services – Effective October 28, 2023 
• Louisiana Medicaid Pharmacy Counseling for Vaccines – Implementation Postponed to October 28, 2023 
• Louisiana Medicaid Pharmacy COVID-19 Vaccines 2023-2024 Update 
• Louisiana Medicaid Pharmacy Maintenance Medications Professional Dispensing Fee for Managed Care Organizations (MCOs) – Implementation Postponed to October 28, 2023 

 Also in Louisiana, the Single Pharmacy Benefits Manager (PBM) for Managed Care Organizations (MCO) original implementation of October 1 was postponed until October 28, 2023. Magellan Medicaid Administration Inc. will serve as the processor for all Medicaid MCO pharmacy for all six MCOs (Aetna, AmeriHealth Caritas, Healthy Blue, Humana Healthy Horizons, Louisiana Healthcare Connections and United Healthcare). Currently Magellan is only processing test claims. If you would like to submit test claims, please e-mail RxPharmacyTesting@magellanhealth.com your contact’s name, phone number, pharmacy National Provider Identifier and Switch information to receive the testing packet. 

Finally in Louisiana, two-term Attorney General Jeff Landry (R) triumphed in the Louisiana governor’s race in a crowded field with more than a dozen candidates. Landry flipped the seat to the GOP, receiving over 51% of the vote last Saturday in the state’s so-called “jungle primary” election where all the candidates in both parties are on the same ballot. Gov. John Bel Edwards (D) was termed limited and could not seek election to a third term. For those state legislative and statewide office races where no one received more 50% of the vote, the top two contenders will face off in the November 18 general election. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

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.

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.

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. 

Finally in Louisiana, the next scheduled meeting of the Council on Medicaid Pharmacy Reimbursement is on September 13. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Recognized by her peers from across the state as someone dedicated to the advancement of the profession of pharmacy, Jennifer Dupree, RPh with Walmart, was honored by NACDS at the Louisiana Pharmacists Association’s annual meeting as the 2023 Louisiana Chain Pharmacist of the Year.  

Also in Louisiana, the Department of Health’s (LDH (Louisiana Department of Health)) 17-page August 2023 Provider Update is on Medicaid’s website.  

Also in Louisiana, here are two additional updates of interest to pharmacies. 

• Louisiana Medicaid Pharmacy Adult Vaccine Coverage Policy Update – Effective August 1, 2023 
• Louisiana Medicaid Pharmacy Diabetic Supplies Update – Effective October 1, 2023 

Also in Louisiana, the Board of Pharmacy summarized new laws adopted in 2023 which impact the practice of pharmacy or Board operations.  

Finally in Louisiana, the Board of Pharmacy quarterly Board meeting was held on August 16 at the Board office in Baton Rouge. The agenda and meeting materials are available here. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Effective October 1, 2023, Medicaid will reimburse continuous glucose monitors and other diabetic supplies as a pharmacy benefit.  

Also in Louisiana, the Department of Health (LDH) and its vendor Magellan Medicaid Administration (MMA) finally held an online seminar on July 17 detailing their plans to migrate to a Single MCO PBM on October 1, 2023. Pharmacy stakeholders were briefed on their plans to open a portal with on-line training videos and a testing window beginning on August 1. All pharmacies need to have a signed contract with MMA. New ID cards will be mailed by mid-September, but the Member’s ID number will remain the same, so no crosswalk is needed. 

Also in Louisiana, by line-item vetoing certain sections in HB 1, the state’s budget bill, Gov. John Bel Edwards (D) restored the $100 million reduction in funding to Louisiana Department of Health (LDH). Had the Governor not acted, the cuts would have caused loss of funding and federal matching funds, totaling between $400 million and $700 million. 

Also in Louisiana, Gov. John Bel Edwards (D) vetoed two school vaccine bills, HB 182 and HB 399, that the Governor feared could undermine public confidence in vaccines. The Legislature has an Override Veto Session scheduled to convene on July 18. 

Also in Louisiana, the Department of Health posted several provider notices of interest to pharmacies: 

• Louisiana Medicaid Pharmacy Point of Sale Quantity Limits – Effective July 1, 2023 
• Louisiana Medicaid Pharmacy Point of Sale (POS) Diagnosis Code Requirement – Effective July 1, 2023 
• Louisiana Medicaid Pharmacy Point of Sale Clinical Authorization and Updates – Effective July 1, 2023 

Finally in Louisiana, the Board of Pharmacy published two rules in the Louisiana Register with immediate effective dates.  

• Regulatory Project 2022-06 – Nonresident Pharmacies amended the rules for nonresident pharmacies to replace the term “out-of-state” with “nonresident,” create parity between nonresident and resident pharmacy requirements, clarify intent and modify the responsibility on the pharmacist-in-charge (PIC) in the matter of policy and procedures. The rule was also amended to remove the requirement for nonresident pharmacies to designate a resident agent and registered office in Louisiana.  

• Regulatory Project 2022-09 – Partial Fills of CDS (Controlled Substances) Prescriptions amended Sections 2735 and 2747 of rules relative to prescriptions for controlled dangerous substances (CDS). The change in Section 2735 places a requirement on pharmacies dispensing prescriptions for CDS to use a dispensing information system capable of accurately recording partial fills and refills of such prescriptions. The change in Section 2747 places a requirement on a pharmacist to dispense a partial fill of a prescription for a CDS when requested by the patient or prescriber, subject to the pharmacist’s obligation relative to corresponding responsibility. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The legislature adjourned its fiscal session at 6:00 p.m. on June 8. Hours prior to adjournment, HB 471, legislation that would allow pharmacists, pharmacy interns supervised by a pharmacist and licensed technicians supervised by a pharmacist to administer immunizations to individuals seven years of age or older, passed the Senate after the conference committee stripped the killer Vaccines for Children amendments from the bill. However, the bill failed to pass the House; it was three votes short. The final House vote was 50-45, and we needed 53 votes for the bill to pass.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

HB 471, by Rep. Barbara Freiberg (R) allowing pharmacists, pharmacy interns supervised by a pharmacist, and licensed technicians supervised by a pharmacist to administer immunizations to individuals seven years old or older, passed the Senate Health and Welfare Committee on May 31 without amendments by a 5-2 favorable vote, and is now pending Senate floor action for a final vote. Pharmacies need to contact state senators in their community and urge a YES vote on the Senate floor. The legislature is scheduled to adjourn on June 8.

For more information, contact NACDS’ Mary Staples at 817-442-1155.