Louisiana Medicaid: Prior Authorization policy updates for brand name and generic drugs

Effective May 25, 2022, claims for brand name and generic drugs not included in the preferred drug list/non-preferred drug list process will not require prior authorization. The Louisiana Department of Health has updated its policy for these types of medications. You can now dispense as written (DAW) the following 4 codes for brand name claims processing without prior authorization.

• DAW 1: Brand name medically necessary from prescriber
• DAW 5: Substitution allowed-brand drug dispensed as a generic
• DAW 8: Substitution allowed; generic drug not available in marketplace
• DAW 9: Preferred brand over generic drugs

Note: These codes typically call for a mandatory generic substitution.

Questions?
For more information see Louisiana Department of Health Information Bulletin 22-5.

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