Managed Care Pharmacy and Medical Drug Policies

In accordance with La. R.S. 46:460.51, et seq., prior to adopting, approving, amending, or implementing certain policies or procedures, LDH will publish the proposed policy or procedure for the purpose of soliciting public comments. For this purpose, a policy or procedure, as defined by the statute, shall mean a requirement governing the administration of managed care organizations specific to billing guidelines, medical management and utilization review guidelines, case management guidelines, claims processing guidelines and edits, grievance and appeals procedures and process, other guidelines or manuals containing pertinent information related to operations and pre-processing claims, and core benefits and services.

The following table contains the LDH and managed care organization pharmacy and medical drug policies that are open for public comment. To provide feedback, please complete this form. Refer to the links below the table for archived postings and public comments.

Item Number  Policy/Procedure Date Posted Comment Period Closed Status  Date Posted   Comment Period Closed Status  Status  Document Links
2026-LHCC-MED-872 Zopapogene Imadenovec (Papzimeos) 2/6/26 3/23/26 Pending Zopapogene Imadenovec (Papzimeos)
2026-LHCC-MED-897 Brexucabtagene Autoleucel (Tecartus) 2/6/26 3/23/26 Pending Brexucabtagene Autoleucel (Tecartus)
2026-LHCC-MED-898 Talimogene laherepvec (Imlygic) 2/6/26 3/23/26 Pending Talimogene laherepvec (Imlygic)
2026-LHCC-MED-899 Trastuzumab/Biosimilars, Trastuzumab-Hyaluronidase 2/6/26 3/23/26 Pending Trastuzumab/Biosimilars, Trastuzumab-Hyaluronidase
2026-LHCC-MED-900 Atezolizumab (Tecentriq) 2/6/26 3/23/26 Pending Atezolizumab (Tecentriq)
2026-LHCC-MED-901 Pemetrexed (Alimta, Pemfexy) 2/6/26 3/23/26 Pending Pemetrexed (Alimta, Pemfexy)
2026-LHCC-MED-902 Cemiplimab-rwlc (Libtayo) 2/6/26 3/23/26 Pending Cemiplimab-rwlc (Libtayo)
2026-LHCC-MED-903 Motixafortide (Aphexda) 2/6/26 3/23/26 Pending Motixafortide (Aphexda)
2026-ACLA-MED-128 VEGF Inhibitors 2/6/26 3/23/26 Pending VEGF Inhibitors
2026-PHARM-6 Asthma/COPD - Immunomodulators 2/6/26 3/23/26 Pending Asthma/COPD - Immunomodulators
2026-PHARM-7 Avtozma 2/6/26 3/23/26 Pending Avtozma
2026-PHARM-8 Brinsupri 2/6/26 3/23/26 Pending Brinsupri
2026-PHARM-9 Casgevy 2/6/26 3/23/26 Pending Casgevy
2026-PHARM-10 Dawnzera 2/6/26 3/23/26 Pending Dawnzera
2026-PHARM-11 Ekterly 2/6/26 3/23/26 Pending Ekterly
2026-PHARM-12 Exxua 2/6/26 3/23/26 Pending Exxua
2026-PHARM-13 Heart Disease - Hyperlipidemia, Lipotropics Other 2/6/26 3/23/26 Pending Heart Disease - Hyperlipidemia, Lipotropics Other
2026-PHARM-14 Jascayd 2/6/26 3/23/26 Pending Jascayd
2026-PHARM-15 Louisiana Medicaid ICD-10 Chart 2/6/26 3/23/26 Pending Louisiana Medicaid ICD-10 Chart
2026-PHARM-16 Nypozi 2/6/26 3/23/26 Pending Nypozi
2026-PHARM-17 Oncology Agents - Oral Other 2/6/26 3/23/26 Pending Oncology Agents - Oral Other
2026-PHARM-18 Pain Management - Antimigraine Agents, CGRP Antagonists 2/6/26 3/23/26 Pending Pain Management - Antimigraine Agents, CGRP Antagonists
2026-PHARM-19 Pain Management - Cytokine/CAM Antagonists 2/6/26 3/23/26 Pending Pain Management - Cytokine/CAM Antagonists
2026-PHARM-20 Pain Management - Skeletal Muscle Relaxants 2/6/26 3/23/26 Pending Pain Management - Skeletal Muscle Relaxants
2026-PHARM-21 POS Anzupgo 2/6/26 3/23/26 Pending POS Anzupgo
2026-PHARM-22 POS Asthma/COPD - Immunomodulators 2/6/26 3/23/26 Pending POS Asthma/COPD - Immunomodulators
2026-PHARM-23 POS Brinsupri 2/6/26 3/23/26 Pending POS Brinsupri
2026-PHARM-24 POS Dermatology - Antipsoriatics, Topical 2/6/26 3/23/26 Pending POS Dermatology - Antipsoriatics, Topical
2026-PHARM-25 POS Empaveli 2/6/26 3/23/26 Pending POS Empaveli
2026-PHARM-26 POS Exxua 2/6/26 3/23/26 Pending POS Exxua
2026-PHARM-27 POS Heart Disease - Hyperlipidemia, Anticoagulants 2/6/26 3/23/26 Pending POS Heart Disease - Hyperlipidemia, Anticoagulants
2026-PHARM-28 POS Jascayd 2/6/26 3/23/26 Pending POS Jascayd
2026-PHARM-29 POS Kirsty 2/6/26 3/23/26 Pending POS Kirsty
2026-PHARM-30 POS Oncology - Oral Other 2/6/26 3/23/26 Pending POS Oncology - Oral Other
2026-PHARM-31 POS Pain Management - Skeletal Muscle Relaxants 2/6/26 3/23/26 Pending POS Pain Management - Skeletal Muscle Relaxants
2026-PHARM-32 POS Rhapsido 2/6/26 3/23/26 Pending POS Rhapsido
2026-PHARM-33 POS Zurnai 2/6/26 3/23/26 Pending POS Zurnai
2026-PHARM-34 Rhapsido 2/6/26 3/23/26 Pending Rhapsido
2026-PHARM-35 Sephience 2/6/26 3/23/26 Pending Sephience
2026-PHARM-36 Tyruko 2/6/26 3/23/26 Pending Tyruko
2026-PHARM-37 Vyjuvek 2/6/26 3/23/26 Pending Vyjuvek
2026-PHARM-5 Max Dose Override Buprenorphine 2/2/26 3/19/26 Pending Max Dose Override Buprenorphine
2026-PHARM-1 Wegovy 1/16/26 3/2/26 Pending Wegovy
2026-PHARM-2 POS Wegovy 1/16/26 3/2/26 Pending POS Wegovy
2026-PHARM-3 Max Dose Override Buprenorphine 1/16/26 3/2/26 Pending Max Dose Override Buprenorphine
2026-PHARM-4 POS Opiate Dependence Agents 1/16/26 3/2/26 Pending POS Opiate Dependence Agents
2026-HB-MED-647 Rebyota (fecal microbiota, live – jslm) 1/7/26 2/21/26 Pending Rebyota (fecal microbiota, live – jslm)
2026-HB-MED-648 Zinplava (bezlotoxumab) 1/7/26 2/21/26 Pending Zinplava (bezlotoxumab)
2026-HB-MED-649 Xiaflex (collagenase clostridium histolyticum) 1/7/26 2/21/26 Pending Xiaflex (collagenase clostridium histolyticum)
2026-HB-MED-650 Crysvita (burosumab-twza) 1/7/26 2/21/26 Pending Crysvita (burosumab-twza)
2026-HB-MED-651 Veopoz (pozelimab-bbfg) 1/7/26 2/21/26 Pending Veopoz (pozelimab-bbfg)
2026-HB-MED-652 Nexobrid (anacaulase-bcdb) 1/7/26 2/21/26 Pending Nexobrid (anacaulase-bcdb)
2026-HB-MED-653 Gamifant (emapalumab-lzsg) 1/7/26 2/21/26 Pending Gamifant (emapalumab-lzsg)
2026-HB-MED-654 Prostacyclin Infusion and Inhalation Therapy  1/7/26 2/21/26 Pending Prostacyclin Infusion and Inhalation Therapy 
2026-HB-MED-655 Scenesse (afamelanotide)  1/7/26 2/21/26 Pending Scenesse (afamelanotide) 

Related Info

Surgeon General Evelyn Griffin, MD

Secretary Bruce D. Greenstein

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