MedicaidCoverageHigh impact
Limited Day Supply (New)
Humana·LA · Pharmacy, Pain Management, Sleep Medicine +1 more·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Louisiana Medicaid is implementing new limited day supply restrictions effective October 1, 2025. Specialty drugs and opioids are limited to 30-day supplies, while 14 specific sedative hypnotic medications have strict 7-day limits for new patients and 15-day limits for chronic users within rolling 30-day periods.
Action Required
Before October 1, 2025: Update pharmacy billing system to enforce new quantity limits - 30-day maximum for specialty drugs and opioids, 7-day supply per rolling 30 days for sedative hypnotics in naive patients, and 15-day supply per rolling 30 days for chronic sedative hypnotic users. Configure system to bypass quantity limits when claims include ICD-10 code Z51.5 (palliative care). Train staff on new rolling 30-day calculation requirements and patient eligibility criteria.