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.
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What to do
Action · 3 steps
01Before 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.
02Configure system to bypass quantity limits when claims include ICD-10 code Z51.5 (palliative care).
03Train staff on new rolling 30-day calculation requirements and patient eligibility criteria.
Codes mentioned
Z51.5
Original notice
Limited Day Supply (New)
mcp.humana.com · Always check the source before changing claims.