MedicaidPrior AuthHigh impact
Louisiana Medicaid Pharmacy – Tropical Storm Bertha Preparation – July 2026
Louisiana Medicaid·LA · Pharmacy·Pharmacy
Effective date
Jul 20, 2026
We identified it
Jul 22, 2026
Summary
Louisiana Medicaid is temporarily waiving early refill edits and automatically extending all prior authorizations for non-controlled pharmacy claims through July 28, 2026, to help beneficiaries maintain medication access during Tropical Storm Bertha. These emergency flexibilities apply to both Fee-for-Service and Managed Care Organization claims but explicitly exclude controlled substances.
Action Required
By July 28, 2026: Billing team must update pharmacy claim submission procedures to reflect temporary policy changes. Specifically: (1) Process early refill requests for non-controlled medications without standard refill edit denials for all Louisiana Medicaid FFS and MCO claims; (2) Recognize that all previously approved prior authorizations are automatically extended through July 28, 2026 and do not require resubmission or new authorization requests for non-controlled drugs; (3) Continue to apply all existing controls and requirements for controlled substance refills and prior authorizations—do NOT waive early refill edits or extend prior authorizations for controlled substances. Billing staff should flag and segregate controlled substance claims to ensure they follow normal approval procedures. After July 28, 2026, revert to standard early refill edits and prior authorization renewal requirements. Contact the appropriate FFS pharmacy help desk (800-437-9101) or MCO PBM for plan-specific guidance on claim submission during this emergency period.