Provider Subcontracts In Place for Nov. 1 Bayou Health Pharmacy Carve-In

The three Bayou Health Plans - Amerigroup, LaCare and Louisiana Healthcare Connections - that will begin coordinating pharmacy services for Medicaid recipients in their networks Nov 1. have all received final approval on their provider subcontracts. Pharmacy providers who wish to contract with a health plan to continue serving their Medicaid patients in that plan should contact the plan's Pharmacy Benefit Manager, which is responsible for forming the pharmacy provider network.

Pharmacy Benefit Managers and Contracting Contact Number By Health Plan:

• Amerigroup (CVS/Caremark): 1‐480‐391‐4623
• LaCare (PerformRx): 1‐800‐555‐5690
• Louisiana Healthcare Connections (USScript): 1‐877‐690‐9330

The contract negotiation process is between an individual provider and the plan. DHH does not facilitate provider contracts, though each plan must meet the network adequacy requirements the department established for Bayou Health. The health plans are also required to allow "any willing provider" to join their networks, so long as the provider is a legacy Medicaid pharmacy provider who will accept the terms and conditions of that plan's contract.

Pharmacists are welcome to contract with as many health plans as they wish, and they can remain legacy Medicaid providers to continue treating clients who are not part of these three Bayou Health plans and will receive pharmacy services through the fee-for-service program.

Bayou Health will allow a 30-day grace period after the Nov. 1 carve-in of pharmacy services, so that pharmacy providers who have existing commercial contracts with any of the three Pharmacy Benefit Managers can serve recipients in that plan while their existing contracts are updated for the Medicaid managed care population.

For more information about the Nov. 1 carve-in, including a resource guide for pharmacy providers, an overview of Bayou Health and details on provider education and outreach sessions taking place now, visit www.MakingMedicaidBetter.com and view the "Pharmacy" tab.