ATTENTION PHARMACIES ACCEPTING MEDICAID:
New PBMs for Louisiana Medicaid Health Plans Effective October 1, 2025
On October 1, 2025, Healthy Louisiana will discontinue its single Pharmacy Benefit Manager (PBM) for Medicaid health plans, and pharmacy benefits for each Medicaid health plan will be managed by the PBMs listed in the attachment. The Louisiana Department of Health, the Medicaid health plans, and all involved PBMs are working together to ensure a smooth transition for both members and pharmacies. Click here to view the full notice.
Welcome to Prime Therapeutics State Government Solutions Pharmacy Portal
Welcome to Prime Therapeutics State Government Solutions Pharmacy Portal, administered by Prime Therapeutics, provides support for the Louisiana Medicaid managed care plans' (Aetna Better Health, AmeriHealth Caritas Louisiana, Healthy Blue Louisiana, Humana Healthy Horizons in Louisiana, Louisiana Healthcare Connections, and UnitedHealthcare Community Plan) pharmacy benefit.
magellan.find.pharmacy.drug.search.tools
magellan.find.pharmacy.drug.search.if.a.drug.coveredATTENTION PHARMACIES ACCEPTING MEDICAID:
Louisiana Department of Health
New PBMs for Louisiana Medicaid Health Plans Effective October 1, 2025
On October 1, 2025, Healthy Louisiana will discontinue its single Pharmacy Benefit Manager (PBM) for Medicaid health plans, and pharmacy benefits for each Medicaid health plan will be managed by the PBMs listed in the attachment. The Louisiana Department of Health, the Medicaid health plans, and all involved PBMs are working together to ensure a smooth transition for both members and pharmacies. Click here to view the full notice.
Announcements
ATTENTION PHARMACIES ACCEPTING MEDICAID:
Louisiana Department of Health
New PBMs for Louisiana Medicaid Health Plans Effective October 1, 2025
On October 1, 2025, Healthy Louisiana will discontinue its single Pharmacy Benefit Manager (PBM) for Medicaid health plans, and pharmacy benefits for each Medicaid health plan will be managed by the PBMs listed in the attachment. The Louisiana Department of Health, the Medicaid health plans, and all involved PBMs are working together to ensure a smooth transition for both members and pharmacies. Click here to view the full notice.
LA MCO Compounding Claims Submission
MMA is currently covering compound claims. All compounds must be submitted using the NCPDP version D.0 standard multi-ingredient compound functionality. Therefore, all ingredients must be identified, their units must be indicated, and the ingredient cost for each ingredient must be submitted on the claim.
At least one item in the compound must be a covered drug. Any component of a compound requiring PA will necessitate an approval prior to receiving payment. For additional information, refer to the Payer Specification document on the Plan Portal.
Refer to the LA MCO Compounding Claims Submission document here for more info.
Announcements
LA MCO Compounding Claims Submission
MMA is currently covering compound claims. All compounds must be submitted using the NCPDP version D.0 standard multi-ingredient compound functionality. Therefore, all ingredients must be identified, their units must be indicated, and the ingredient cost for each ingredient must be submitted on the claim.
At least one item in the compound must be a covered drug. Any component of a compound requiring PA will necessitate an approval prior to receiving payment. For additional information, refer to the Payer Specification document on the Plan Portal.
Refer to the LA MCO Compounding Claims Submission document here for more info.