LETTER TO PROVIDERS
October 1, 2002
Dear Prescribing Practitioners and Pharmacy Providers:
Attached
is a listing of drugs to be added to the Medicaid Prior Authorization (PA)
Process' Preferred Drug List (PDL). The
listing includes preferred drugs and those drugs requiring prior authorization
with effective implementation dates shown. Please add this list to the ones previously sent.
The
PA process, in accordance with the program's "Continuity of Care" policy,
does not impact original prescriptions (or refills) issued by a prescribing
practitioner prior to effective PA dates of drugs as they are added to the PA
process as long as they are within the 5 refills
and 6-month program limits.
An educational alert will notify the pharmacist that prescriptions
(and their refills) will require a new prescription and prior authorization if
the prescription life exceeds six months or the refill exceeds the 5 refill
limit. The educational alert will state, "NEW RX WILL REQUIRE PA
AFTER (DATE)."
The
Medicaid PBM Program utilizes a numbering system to assist providers in
maintaining the lists disseminated. You
will note the list included with this correspondence is "02-03." Please be
advised this attachment contains updates to the previously issued Prior
Authorization PDL Implementation Schedules issued May 24, 2002 (Issuance 02-01)
and July 16, 2002 (Issuance 02-02). These
updates are noted on the attachment in bold
and italics
and include the following therapeutic classes: Proton Pump Inhibitors, Inhaled Steroids, and Beta Adrenergic Agents. Some drugs in these therapeutic classes which previously required prior
authorization have been moved to the PDL while others will now require prior
authorization. The
effective dates of these changes are also shown on the chart. It is recommended that you make notations with effective dates on
transmittals whenever changes occur in therapeutic classes to ensure you are
referencing the most current status of a drug. For example, a note on the "Proton Pump Inhibitor" class on
Transmittal 02-01 such as "Obsolete effective October 14, 2002 by Transmittal
02-03" might be helpful. Additionally,
the last page of the attachment contains drug products are
to be removed from the listings as a result of the drug being discontinued or
obsolete.
Information
on the Prior Authorization process, including the PDL and Prior Authorization
Request Form, is also available on the Louisiana Medicaid website (www.lamedicaid.com). This website will be updated when changes (additions or deletions) are
made to the PDL. The program may
also utilize the provider remittance advices to notify providers of PDL changes
that must be implemented in short time frames.
The Department has received inquiries
that drug products requiring PA are not reimbursable by Medicaid. Medicaid does reimburse for drug products requiring prior authorization
when the prior authorization process is followed.
Thank
you for your continued cooperation. We appreciate your participation in the
Medicaid program.
Sincerely,
Ben
A. Bearden
Director
BAB/mjt
The above letter and the Preferred Drug
List are
also available in PDF format on the Downloadable
Forms and Files page.