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.

HB 471, sponsored by Rep. Barbara Freiberg (R), authorizes pharmacists to order and administer, and pharmacy interns and pharmacy technicians to administer immunizations to children aged 7 years and older. The bill passed the House Health and Welfare Committee by a vote of 14-2 on May 16, and it was sent to the full House to be voted on next week. Thanks to Dwana Day with Brookshire Grocery Company, and Albertsons Companies’ pharmacists Ryan LaBarbera and Brittany Tucker for a fantastic job representing their profession by testifying at the House hearing. NACDS and the Louisiana Alliance for Pharmacies strongly urge immediate action contacting all legislators where you operate pharmacies in their district.

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

While HB 471, by Rep. Barbara Freiberg (R) authorizing pharmacists to order and administer, and pharmacy interns and pharmacy technicians to administer immunizations to children aged seven years and older was scheduled to be heard in the House Health and Welfare Committee on May 10, the sponsor asked that the bill be deferred until May 17. The additional time gives chain pharmacies an opportunity to take action and contact House Health and Welfare Committee members urging them to support HB 471 to preserve patient access for children and families to receive lifesaving vaccines at pharmacies. 

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

HB 471 by Rep. Barbara Freiberg (R) authorizing pharmacists to order and administer and pharmacy interns and pharmacy technicians to administer immunizations to children aged seven years and older is scheduled for a hearing in the House Health and Welfare Committee on May 10. The Louisiana Alliance for Retail Pharmacies is urging chain pharmacies to take action to preserve patient access to children and families for lifesaving vaccines at pharmacies. 

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

The Legislature convened their 60-day fiscal session on Monday, April 10th. The House Health Committee has scheduled a hearing on May 10th on HB 471, legislation the Louisiana Alliance of Retail Pharmacies (LARP) initiated that lowers the age to 7 and older for pharmacies to administer all ACIP immunizations and vaccines without a patient specific prescription or medical order.

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