Pharmacy

The Louisiana Department of Health pharmacy services are included as a benefit in managed care. Pharmacy services remain in legacy Medicaid for recipients not enrolled in managed care. Pharmacy provider relations support for legacy Medicaid will continue to be handled by the Medicaid fiscal intermediary, Molina.

Pharmacy News

Pharmacy Resources

Preferred Drug Lists (PDL)

 Questions can be directed by plan as follows:

Aetna

  • General Provider Issues - Call Provider Relations - 1-855-242-0802
  • Pharmacy Contracting Issues - Call CVS Health - 1-855-364-2977
  • Aetna Member with Issues - Have the Member Call Member Services - 1-855-242-0802
  • Claims/Billing Issues - Call CVS Health - 1-855-364-2977
  • Pharmacy Billing Information
    • BIN: 610591
    • PCN:ADV
    • Group: RX8834

AmeriHealth Caritas

  • General Provider Issues - Call PerformRx Provider Relations - 1-800-684-5502
  • Pharmacy Contracting Issues - Call PerformRx - 1-800-555-5690
  • AmeriHealth Caritas Member with Issues - Have the Member Call Perform Rx Member Services - 1-866-452-1040
  • Claims/Billing Issues - Call PerformRx - 1-800-684-5502
  • Pharmacy Billing Information
    • BIN: 600428
    • PCN: 06030000

Healthy Blue

  • General Provider Issues - Call Provider Relations - 1-844-521-6942
  • Pharmacy Contracting Issues - Call Express Scripts - 1-888-571-8182
  • Amerigroup Member with Issues - Have the Member Call Member Services - 1-844-521-6941
  • Claims/Billing Issues - Call Express Scripts - 1-844-367-6111
  • Pharmacy Billing Information
    • BIN: 003858
    • PCN: MA
    • Group: WKLA

Louisiana Healthcare Connections

  • General Provider Issues - Call Provider Relations - 1-866-595-8133
  • Pharmacy Contracting Issues - CVS Caremark 1-800-311-0543
  • Louisiana Healthcare Connections Member with Issues - Have the Member Call Member Services - 1-866-595-8133
  • Claims/Billing Issues - Call CVS Caremark Pharmacy Help Desk – 1-800-311-0543
  • Pharmacy Prior Authorization - Call Envolve Pharmacy Solutions - 1-888-929-3790 
  • Pharmacy Billing Information 
    • BIN: 004336
    • RXPCN: MCAIDADV
    • RXGRP: RX5444
    • Member ID Format: 13 digit

United Healthcare

  • General Provider Issues - Call Provider Relations - 1-866-675-1607
  • Pharmacy Contracting Issues - Call OptumRx - 1-800-797-9798
  • United Healthcare Member with Issues - Have the Member Call Member Services - 1-866-675-1607
  • Claims/Billing Issues - Call OptumRx - 1-866-328-3108
  • Pharmacy Billing Information
    • BIN: 610494
    • PCN: 9999
    • Group: ACULA

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 healthy@la.gov, and the appropriate staff will address any issues or concerns. Staff are typically able to respond within one business day.

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

Pharmacy Education & Outreach Materials

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