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.