MedicaidCoverageMedium impact
Non-FDA Approved Medications (New)
Humana·LA · Pharmacy, OB-GYN·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
New Louisiana Medicaid policy establishes that non-FDA approved medications are generally excluded from formulary coverage, with rare exceptions only for medications specifically reviewed and approved by Humana's Pharmacy and Therapeutics Committee (such as 17-P for preterm delivery prevention). This creates potential coverage denials for any non-FDA approved medications not on the approved list.
Action Required
Before October 1, 2025: Billing and clinical teams must review current non-FDA approved medication prescriptions for Louisiana Medicaid patients and verify coverage status with Humana's approved list. Update prior authorization workflows to check FDA approval status before submitting pharmacy claims. Train providers to identify non-FDA approved medications and consider FDA-approved alternatives when available.