The Medicaid Pharmacy Benefit Management Program administers several prescription services for recipients and providers.
Drug Rebate Programs
The Pharmacy Benefits Management Program administers the federally mandated drug rebate program and the State Supplemental Drug Rebate Program for Louisiana’s Medicaid Program. The Pharmacy Benefits Management Section contracts with the University of New Orleans to operate both drug rebate programs.
Pharmacists must bill the actual NDC of the drug dispensed to ensure that the rebate paid by the drug manufacturer is correct. Manufacturers are allowed to audit utilization data of both rebate programs. The Medicaid Pharmacy Benefits Management Section also audits this data to ensure accurate provider billing as this data is used to calculate the rebate amounts. Providers may be contacted by rebate staff in an effort to resolve rebate disputes with the manufacturers. Providers must respond to the auditor’s request for information. The state supplemental and federal unit rebate amounts are confidential and cannot be disclosed for purposes other than rebate invoicing and verification.
As per the Medicaid Tamper Resistant Prescription Pad Law, beginning April 1, 2008, all non-electronic prescriptions to be paid by Medicaid for outpatient drugs must be submitted on a prescription pad containing all of the following tamper-resistant characteristics:
- One or more industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form;
- One or more industry-recognized features designed to prevent the erasure or modification of information written on the prescription pad by the prescriber; and
- One or more industry-recognized features designed to prevent the use of counterfeit prescription form.
Click here for more information on tamper resistant prescription criteria.