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	Comment Period Closed Status	Status	Document Links
2026-UHC-MED-267	Gazyva	1/7/26	2/21/26	Pending	Gazyva
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)
2025-PHARM-162	Cytokine/CAM Antagonists	12/12/25	1/25/26	Pending	Cytokine/CAM Antagonists
2025-HUMANA-MED-175	Lanretotide	12/11/25	1/25/26	Pending	Lanretotide
2025-HUMANA-MED-176	Bevacizumab	12/11/25	1/25/26	Pending	Bevacizumab
2025-HUMANA-MED-177	Ustekinumab	12/11/25	1/25/26	Pending	Ustekinumab
2025-HUMANA-MED-178	Eculizumab	12/11/25	1/25/26	Pending	Eculizumab
2025-HUMANA-MED-179	Paclitaxel	12/11/25	1/25/26	Pending	Paclitaxel
2025-HUMANA-MED-181	Ferric carboxymaltose	12/11/25	1/25/26	Pending	Ferric carboxymaltose
2025-HUMANA-MED-183	Aprepitant	12/11/25	1/25/26	Pending	Aprepitant
2025-HUMANA-MED-188	Gemcitabine	12/11/25	1/25/26	Pending	Gemcitabine
2025-UHC-MED-261	Gamifant	12/11/25	1/25/26	Pending	Gamifant
2025-UHC-MED-262	Luxturna	12/11/25	1/25/26	Pending	Luxturna
2025-UHC-MED-263	Maximum dosage	12/11/25	1/25/26	Pending	Maximum dosage
2025-UHC-MED-264	Botulinum toxins	12/11/25	1/25/26	Pending	Botulinum toxins
2025-UHC-MED-265	Rebyota	12/11/25	1/25/26	Pending	Rebyota
2025-HB-MED-617	Papzimeos	12/5/25	1/19/26	Pending	Papzimeos
2025-HUMANA-MED-170	Tocilizumab	12/5/25	1/19/26	Pending	Tocilizumab
2025-HUMANA-MED-171	Romiplostim	12/5/25	1/19/26	Pending	Romiplostim
2025-HUMANA-MED-172	Infliximab and its biosimilars	12/5/25	1/19/26	Pending	Infliximab and its biosimilars
2025-HUMANA-MED-173	Pembrolizumab	12/5/25	1/19/26	Pending	Pembrolizumab
2025-HUMANA-MED-174	Nivolumab	12/5/25	1/19/26	Pending	Nivolumab

---

---

---

---

Related Info

• Previously posted for public comment
• Managed Care Pharmacy and Medical Drug Policies - Archive (2024)
• Managed Care Pharmacy and Medical Drug Policies - Archive (2023)
• Managed Care Pharmacy and Medical Drug Policies - Archive (2022)
• Managed Care Pharmacy and Medical Drug Policies - Archive (2021 and prior)
• Public comments submitted