The Board of Pharmacy Regulation Revisions Committee will be meeting on October 11 at their office in Baton Rouge to discuss these regulatory proposals.  

Also in Louisiana, the Department of Insurance Office of the Commissioner promulgated Regulation 122 defining the roles and responsibilities solely within the purview of pharmacy benefit managers and pharmacy services administrative organizations. 

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

The Department of Health’s (LDH) deadline for Medicaid providers to submit an enrollment application is September 20, 2022. Claims will be denied beginning December 31, 2022, for providers who have not completed the enrollment process by September 30. Providers should visit www.lamedicaid.com to enroll. Additional guidance is located at www.ldh.la.gov/medicaidproviderenrollment. Providers can also email questions to LouisianaProvEnroll@gainwelltechnologies.com or call 833-641-2140.

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

The Department of Health (LDH (Louisiana, the Department of Health)) Medicaid Pharmacy Facts includes detailed information on Medicaid’s Fee-for-Service (FFS) Pharmacy Program and the managed care organizations (MCO) coverage and reimbursements for flu and COVID booster. 

• Effective September 15, 2022, enrolled pharmacies will be reimbursed for the influenza vaccines and administration of the vaccines when given to Medicaid recipients, who are 19 years of age and older when the administering pharmacist is an enrolled Medicaid provider. The cost of the vaccine will not be reimbursed for recipients under the age of 19, only the administration fee will be reimbursed, as these vaccines are available through the Louisiana Vaccines for Children (VFC) program. The Louisiana Board of Pharmacy rules and regulations allow a vaccinating pharmacist to administer the influenza vaccine to individuals seven years of age and older. 
•  On September 23, 2022, with an effective date of August 31, 2022, the Louisiana Medicaid’s Fee-for-Service (FFS) Pharmacy Program and the managed care organizations (MCO) are covering the bivalent COVID-19 vaccine booster, with Emergency Use Authorization (EUA). The federal government covers the cost of the COVID-19 vaccine. Therefore, Louisiana Medicaid will reimburse enrolled pharmacies the administration fee only. Coverage for the Pfizer, Janssen (Johnson & Johnson), and Moderna COVID-19 primary vaccine series will continue. 
• Louisiana Medicaid is hosting a series of provider webinars regarding the upcoming Provider Enrollment deadline. 

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

The Department of Insurance (LDI) released a summary report on the process of promulgating Regulation 122, which defines the roles and responsibilities solely within the purview of pharmacy benefit managers and pharmacy services administrative organizations as required by a newly enacted statute, R.S. 22:1660.9(C).

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

The Department of Health (LDH) issued a Provider Bulletin to inform all providers rendering services to Louisiana Medicaid members with updates on COVID-19 covered services.

Also in Louisiana, the Board of Pharmacy announced Joe Fontenot, Jr, RPh (registered pharmacists) as their new Executive Director, replacing Malcolm Broussard who retired after serving 23 years.

Finally in Louisiana, the Board issued Bulletin No. 22-01 – Status of Interim Policies From COVID-19 Declaration of Emergency, terminating some of the policies effective May 31, 2022, and further extending some of the policies including the 4:1 pharmacy technician ratio until the end of the calendar year.

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

Walgreens pharmacist Troy Menard, a member of the Louisiana Board of Pharmacy, was chosen by his peers and honored by NACDS at the Louisiana Pharmacist Association Annual Convention’s award ceremony as the “2022 Chain Pharmacist of the Year.” {PHOTO Left to right: Walgreens pharmacists Jeff Gaude with Troy Menard} 

Also in Louisiana, effective July 1st, the Medicaid Fee for Service Pharmacy Program and Managed Care Organizations will be reduced 30-cents from $37.08 to $36.78 to align with the Medicare rate and Louisiana Medicaid Professional Services. No dispensing fee shall be reimbursed, only an administration fee. At home, administration of the COVID-19 vaccine for any dose will be increased 38-cents from $32.60 to $32.98 for a total reimbursement of $69.76 ($32.98 + $36.78) or billed charges, whichever is the lesser amount.  

Also in Louisiana, the Department of Health (LDH) Bureau of Health Services Financing sent a reminder memo that Medicaid will begin denying claims on December 31, 2022, for providers that have not completed the enrollment process through the Medicaid Provider Enrollment Portal by September 30. 

Also In Louisiana, Gov. John Bel Edwards signed into law HB 673/Act 723 that establishes a new Pharmacy Benefit Manager Advisory Council. Both NACDS and our in-state partner, the Louisiana Alliance for Retail Pharmacies (LARP) have designated seats on the Council. The purpose of the Council is to provide monitoring of pharmacy benefit managers in Louisiana to advise the legislature, commissioner of insurance, and Board of Pharmacy on the most effective and efficient manner of regulation of pharmacy benefit managers to ensure the protection of the public. 

Also in Louisiana, on July 13th both the Prescription Benefits Manager Monitoring Advisory Council (PBM-MAC) and the Pharmacy Benefit Manager Council (PMPAC) held in-person meetings in Baton Rouge. NACDS has designated seats on both Councils. 

Finally in Louisiana, on July 1, Medicaid implemented a new preferred drug list (PDL). There were no new therapeutic classes added to the PDL at the spring 2022 Pharmaceutical & Therapeutics (P&T) Committee meeting.  

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

The legislature adjourned its regular session on June 6. 

Also in Louisiana, the Department of Health’s (LDH) deadline for Medicaid Provider Portal enrollment is June 30, 2022. All current providers must validate their information and sign the state’s provider participation agreement.  

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

The Department of Health (LDH) has recently updated its Medicaid COVID-19 vaccine billing schedule adding reimbursement for booster doses for ages 5-11. 

Also in Louisiana, LDH requested NACDS remind pharmacies that file claims with Louisiana Medicaid must enroll in Medicaid’s new web‐based provider enrollment portal by June 30, 2022. Any existing Medicaid providers that do not submit an application to initiate the screening process through the new portal will have their claims denied.

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

HB (House Bill) 424 by Rep. Chris Taylor (R), legislation lowering the age to 7 and older for pharmacies to be able to provide immunizations without a prescription, fell one vote short of the 53 votes needed to pass the full House; final passage vote was 52 in favor and 37 opposed. 

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