Pharmacy Clinical Authorization Requirement for GLP-1 Agonists Starts November 15, 2024
Date: 10/15/24
Effective November 15, 2024, the Louisiana Medicaid Preferred Drug List (PDL) will be updated with clinical authorization criteria for all glucagon-like peptide-1 (GLP-1) receptor agonists, including both preferred and non-preferred agents.
This clinical authorization requirement is in alignment with the Louisiana Department of Health (LDH) Imminent Peril Justification to ensure appropriate utilization for the GLP-1 medications.
Requests for GLP-1 medications will be approved after clinical authorization review for patients who meet the clinical criteria listed on the LDH PDL and meet all appropriate age requirements.
Action Requested:
Louisiana Medicaid providers are advised to review their current patients prescriptions that will now require clinical authorization.
Current prescribers of preferred GLP-1 medications for any Louisiana Healthcare Connections members were mailed a notification letter with patient information ahead of the change to allow for time and notice to complete the appropriate clinical authorization. Continuity of Care provisions are provided to members currently receiving the medication until December 23, 2024 to aid in the transition.
LHCC has notified your patient(s) of this change with a mailed notification letter in accordance with State requirements.
Starting November 15, 2024:
To initiate a clinical authorization for GLP-1 medications, providers should submit a Prior Authorization on the Uniform PA Form and all applicable clinical documentation to Magellan Medicaid Administration (MMA):
- To Submit by Phone: 1-800-424-1664
- To Submit by Fax: 1-800-424-7402
- To Submit Online: www.CoverMyMeds.com
All pharmacy benefit clinical authorization requests receive a decision within 24 hours of receiving all necessary information.
If you have any questions, please call the Pharmacy Help Desk at 1-800-424-1664.
Thank you for your collaboration in ensuring safe and appropriate medication use for your patients, our members.