Transition for maintenance and behavioral health medications
If a member who is new to AmeriHealth Caritas Louisiana and was previously on a maintenance medication or behavioral health medication that is either not on the Louisiana Medicaid Single PDL, or is on the Louisiana Medicaid Single PDL but requires prior authorization, AmeriHealth Caritas Louisiana will authorize a transition supply to allow time for the physician to consider an alternative product on our formulary or to submit a request for the member to continue on existing therapy.
Maintenance medication will be authorized for 60 days. Antidepressants and antipsychotics will be continued for 90 days.
- The dispensing pharmacy may contact PerformRx Provider Services Help Desk at 1-800-684-5502 to request a transition supply on behalf of the member. The pharmacy will need to verify the date of the last fill.
- The prescribing physician may contact PerformRx Provider Services Help Desk at 1-800-684-5502 to request a transition supply on behalf of the member. The physician will need to state when the medication was first started and will be encouraged to consider an alternative medication on our formulary or submit a prior authorization immediately.
- The member may contact Pharmacy Member Services at 1-866-452-1040 to request a transition supply. The member will need to provide the pharmacy's name and phone number so the pharmacy can be contacted directly to verify the date of the last fill.