Louisiana Department of Health & Hospitals | Bruce Greenstein, Secretary

Pharmacy

The Louisiana Department of Health and Hospitals added pharmacy as a benefit under the three Prepaid Bayou Health Plans - Amerigroup, LaCare and Louisiana Healthcare Connections - effective Nov. 1, 2012. Pharmacy services remain in legacy Medicaid for recipients in the two Shared Savings Bayou Health Plans - Community Health Solutions and United Healthcare - and pharmacy provider relations support will continue to be handled by the Medicaid fiscal intermediary, Molina.

Pharmacy News

• Amerigroup Louisiana Pharmacy and Therapeutics Advisory Committee Meeting Invitation
• Standard Prior Authorization Form to Go Live in June
• Pharmacy Services Coverage Emergency Rule
• Bayou Health Resource Guide for Pharmacy Providers
• Pharmacy Reform Fact Sheet
• Transitioning to Managed Care: A Notice to Providers
• Transitioning to Managed Care: A Notice to Members
• Notice to Providers - Influenza Vaccine
• Legacy Medicaid Pharmacy Reimbursement Changes (10.26.2012)
  

Pharmacy Resources for Providers

Questions can be directed by plan as follows:

Amerigroup

• General Provider Issues - Call Provider Relations - 1-800-454-3730
• Pharmacy Contracting Issues - Call CVS/Caremark - 1‐480‐391‐4623
• Amerigroup Member with Issues - Have the Member Call Member Services - 1-800-600-4441
• Claims/Billing Issues - Call CVS/Caremark - 1‐800-364-6331

LaCare

• General Provider Issues - Call PerformRx Provider Relations - 1-888-684-5502
• Pharmacy Contracting Issues - Call PerformRx - 1‐800‐555‐5690
• LaCare Member with Issues - Have the Member Call Perform Rx Member Services - 1-888-452-1040
• Claims/Billing Issues - Call PerformRx - 1-888-922-0007

Louisiana Healthcare Connections

• General Provider Issues - Call Provider Relations -1-866-595-8133
• Pharmacy Contracting Issues - Call USScript - 1‐877‐690‐9330
• Louisiana Healthcare Connections Member with Issues - Have the Member Call Member Services - 1-866-595-8133
• Claims/Billing Issues - Call Provider Relations - 1-866-595-8133

Community Health Solutions

• General Provider Issues - Call Provider Relations - 1-855-247-5248
• Pharmacy Contracting Issues - Call Molina Provider Relations - 1‐877‐690‐9330
• Community Health Solutions Member with Issues - Have the Member Call Member Services - 1-855-247-5248
• Claims/Billing Issues - Call Provider Relations 1-855-247-5248

United Healthcare

• General Provider Issues - Call Provider Relations - 1-866-675-1607
• Pharmacy Contracting Issues - Call Molina Provider Relations - 1‐877‐690‐9330
• United Healthcare Member with Issues - Have the Member Call Member Services - 1-866-675-1607
• Claims/Billing Issues - Call Provider Relations 1-866-675-1607

Any other pharmacy-related questions can be directed to the Medicaid Pharmacy Program at 1-800-437-9101. Pharmacists seeking clarification on average acquisition costs in the fee-for-service Medicaid program should contact the Myers & Stauffer Pharmacy Reimbursement Help Desk at 1-800-591-1183

Providers can also submit questions by email to bayouhealth@la.gov, and the appropriate staff will address any issues or concerns. Staff are typically able to respond within one business day.

DHH continues to hold a provider phone call at noon each Wednesday to address providers' Bayou Health questions. Any provider is welcome to call in, and pre-registration is not required. The call in number is 1-888-278-0296, and the access code is 6556479#.

Pharmacists and prescribing providers are strongly encouraged to review Informational Bulletins pertaining to the pharmacy integration:

Transition of Care Procedures

• Amerigroup
• LaCare
• Louisiana Healthcare Connections

Pharmacy Integration materials

• Transition Reports by Health Plan
  • Amerigroup
  • LaCare
  • Louisiana Healthcare Connections
• DHH Executive Counsel Opinion on Taxation of Pharmaceutical Benefits
• Prepaid Plan Formulary and Preferred Drug List Information
• Synagis Protocols By Health Plan
  • Amerigroup
  • LaCare
  • Louisiana Healthcare Connections 
• Bayou Health Executed Contracts
• Health Plan Member Cards - Pharmacy Cards:
  • Amerigroup
  • LaCare
  • Louisiana Healthcare Connections (front and back)
• MEVS Help Guide

Pharmacy Education & Outreach Materials

• Final Reform Concept - 8.24.2012
• Preferred Drug List Legislative Report - January 2012
• Pharmacy Forums Presentation: Modernizing Louisiana's Medicaid Pharmacy Program: Prescription for Reform
• Initial concept paper: Modernizing Louisiana's Medicaid Pharmacy Program
• Bayou Health Pharmacy Forum Resources

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