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Pharmacy PA guidelines
When you request prior authorization (PA) for a drug on the PDL, we use the Healthy Louisiana PDL clinical criteria to make decisions.
Healthy Louisiana guidelines and policies
Healthy Louisiana pharmacy clinical criteria (PDF)
Electronic PA (ePA)
You need the right tools and technology to help our members. That’s why we’ve partnered with CoverMyMeds® and Surescripts to provide a new way to request a pharmacy PA with our ePA program.
With ePA, you can look forward to saving time with:
Less paperwork
Fewer phone calls and faxes
Quicker determinations
Safe and secure HIPAA-compliant submitted requests
Easy upload of clinical documents
Enroll now
Getting started with ePA is free and easy. You’ll need this info to enroll:
- BIN: 610591
- Group: RX881J
- PCN: MCAIDADV
How to enroll
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Online
Visit the CoverMyMeds website.
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By phone
Call CoverMyMeds at 1-866-452-5017.
Other ways to request PA
If you don’t want to enroll in ePA, you can request PA:
Online
You can request PA through our secure Provider Portal.
Portal para proveedores
By phone
You can request PA by calling us at 1-855-242-0802 (TTY: 711).
By fax
Check “Request forms” in the next section to find the right form. Then, fax it with any supporting documentation for a medical necessity review to 1-844-699-2889.
Request forms
If you don’t see the right form in the list, you can use the uniform prescription drug PA form (PDF). Otherwise, check for the drug class or drug name that matches your needs:
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