Provider Reminder: Diabetic Supplies Coverage as a Pharmacy Benefit
Date: 01/30/25
Louisiana Healthcare Connections is reminding all Medicaid providers that Louisiana Medicaid reimburses continuous glucose monitors and other diabetic supplies as a pharmacy benefit only for dates of service on or after December 1, 2023, in accordance with La. R.S. 46:450.8. These diabetic supplies are billed as a pharmacy benefit using National Drug Code (NDC).
- Diabetes glucose meters
- Diabetic test strips
- Continuous glucose meters
- Transmitters and sensors
- External insulin pumps (e.g., Cequr Simplicity, Omnipod and V-Go)
- Control solution
- Ketone test strips
- Lancets and devices
- Pen needles
- Re-usable insulin pens
- Syringes
Please note: Implantable insulin pumps that require tubing are still billed via the DME program.
LHCC follows the Louisiana Medicaid Diabetic Supplies Preferred Drug List (PDL), which includes links to clinical criteria and any applicable quantity limits or diagnosis requirements.
Clinical authorization or prior authorization requests for any diabetic supplies on the pharmacy benefit, if required, may be submitted one of the following ways with appropriate clinical justification:
- Phone: Call Pharmacy Prior Authorization at 1-800-424-1664
- Fax: Utilize the Uniform PA Form and fax to 1-800-424-7402
- Electronic: https://www.covermymeds.com/
For additional information, please reference Informational Bulletin 23-11 posted by the Louisiana Department of Health.