Pharmacy

The Louisiana Department of Health pharmacy services are included as a benefit in managed care. Pharmacy services remain in legacy Medicaid for recipients not enrolled in managed care. Pharmacy provider relations support for legacy Medicaid is handled by the Medicaid fiscal intermediary, Gainwell Technologies.

Louisiana Medicaid Single Preferred Drug List (PDL)

Pharmacy Resources

Pharmacy Facts

Pharmacy News

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Contacts 

Questions can be directed by plan as follows:

Aetna

  • General Provider Issues - Call Provider Relations - 1-855-242-0802
  • Pharmacy Contracting Issues - Call CVS Health - 1-855-364-2977
  • Aetna Member with Issues - Have the Member Call Member Services - 1-855-242-0802
  • Claims/Billing Issues - Call CVS Health - 1-855-364-2977
  • Pharmacy Billing Information
    • BIN: 610591
    • PCN:ADV
    • Group: RX8834

AmeriHealth Caritas

  • General Provider Issues - Call PerformRx Provider Relations - 1-800-684-5502
  • Pharmacy Contracting Issues - Call PerformRx - 1-800-555-5690
  • AmeriHealth Caritas Member with Issues - Have the Member Call Perform Rx Member Services - 1-866-452-1040
  • Claims/Billing Issues - Call PerformRx - 1-800-684-5502
  • Pharmacy Billing Information
    • BIN: 019595
    • PCN: 06030000

Healthy Blue

  • General Provider Issues - Call Provider Relations - 1-844-521-6942
  • Pharmacy Services
    • Pharmacy Contracting Issues - Call CVS - 1-866-488-4708
    • Member Pharmacy Services - 1-833-207-3114
    • Pharmacy provider help desk for claim processing: 1-833-236-6194
    • Pharmacy Billing Information
      • BIN: 020107
      • PCN: FG
      • Group: WKLA

Louisiana Healthcare Connections

  • General Provider Issues - Call Provider Relations - 1-866-595-8133
  • Pharmacy Contracting Issues - CVS Caremark 1-800-311-0543
  • Louisiana Healthcare Connections Member with Issues - Have the Member Call Member Services - 1-866-595-8133
  • Claims/Billing Issues - Call CVS Caremark Pharmacy Help Desk – 1-800-311-0543
  • Pharmacy Prior Authorization - Call Envolve Pharmacy Solutions - 1-888-929-3790 
  • Pharmacy Billing Information 
    • BIN: 004336
    • RXPCN: MCAIDADV
    • RXGRP: RX5444
    • Member ID Format: 13 digit

United Healthcare

  • General Provider Issues - Call Provider Relations - 1-866-675-1607
  • Pharmacy Contracting Issues - Call OptumRx - 1-877-633-4701
  • Pharmacy Credentialing - Call OptumRx - 1-800-613-3591
  • United Healthcare Member with Issues - Have the Member Call Member Services - 1-866-675-1607
  • Claims/Billing Issues - Call OptumRx - 1-866-328-3108
  • Pharmacy Billing Information
    • BIN: 610494
    • PCN: 9999
    • Group: ACULA

Fee For Service

  • General Provider Issues - Call Provider Relations:1-800-473-2783
  • Pharmacy Contracting Issues - Call Gainwell Technologies –Provider Enrollment: 1-225-216-6370
  • Pharmacy Credentialing - Call Gainwell Technologies--Provider Enrollment: 1-225-216-6370
  • Pharmacy Claims/Billing Issues - Call POS Help Desk: 1-800-648-0790 or 225-216-6381
  • Pharmacy Billing Information –  Call POS Help Desk: 1-800-648-0790 or 225-216-6381
    • BIN: 610514 
    • PCN: LOUIPROD
    • Group: n/a
  • Provider Enrollment Portal Issues:  Call: 1-833-641-2140 or email @:  LouisianaProvEnroll@gainwelltechnologies.com

Any other pharmacy-related questions can be directed to the Medicaid Pharmacy Program at 1-800-437-9101. 

Providers can also submit questions by email to healthy@la.gov, and the appropriate staff will address any issues or concerns. Staff are typically able to respond within one business day.

Pharmacists and prescribing providers are strongly encouraged to review Informational Bulletins pertaining to the pharmacy integration.

RELATED INFO

 

Subscribe

Subscribe to learn when new or amended informational bulletins are posted to the website and have other important  information delivered to your inbox.