PHARMACY PROVIDERS, PLEASE NOTE!!!

If you are unsure about the coverage of a drug product, please contact the PBM help desk at 1-800-648-0790.

Please file adjustments for claims that may have been incorrectly paid. Only those products of the manufacturers which participate in the Federal Rebate Program will be covered by the Medicaid program. Participation may be verified in Appendix C, available at http://www.lamedicaid.com. 

Should you have any questions regarding any of the following messages, please contact Gainwell Technologies at (800) 473-2783 or (225) 924-5040.

For information regarding the medication policy and/or criteria associated with this denial, providers may access the Louisiana Medicaid Preferred Drug List (PDL) / Non-Preferred Drug List at http://ldh.la.gov/assets/HealthyLa/Pharmacy/PDL.pdf.

2024 Annual 1099 Notice for Providers

Louisiana Medicaid 2024 1099’s will be distributed by U.S. Mail on or before January 31, 2025. Electronic copies are now available for download by going to the Louisiana Medicaid website, www.lamedicaid.com, Secure Portal, application link, Online 1099. If replacement copies or additional copies are needed, providers must print them from the website. If you feel there is an error on your 1099, please contact Gainwell Provider Enrollment at 225-216-6370. Prior year 1099’s will be stored in the archive on www.lamedicaid.com.

Reminder to All Providers

To ensure timely and accurate processing of claims please follow these guidelines for claim submission.

CLAIM FORMS must comply with CMS Standard size and in color. (INK-Flint, OCR red J6983).

KEY GUIDELINES Black ink only; no copied, faxed, or black and white claims; align data within each field; no highlighting, staples, tape, or clips.

CMS 1500 MARGINS -top 0.35", Bottom 0.3", Left 0.13", right 0.1".

UB-04 MARGINS A standard UB-04 form is 8.5x11 paper and printed edge to edge. The exact margin measurements may vary depending on the vendor or software used to generate the form.

Refer to the CMS website for additional information.

Beginning March 3, 2025, non-compliant claims will be returned for correction and resubmission.

For questions, contact Gainwell Provider Relations at 1-800-473-2783 or 225-924-5040.