LOUISIANA STATE MEDICAL SOCIETY
AM 2024 DESTIN
HOUSE OF DELEGATES
RESOLUTION 101
SUBJECT:
Sunset Directives
INTRODUCED BY:
Board of Governors
WHEREAS, it is the policy of the LSMS to sunset directives after two years, or upon completion, therefore be it RESOLVED, that R102-22 (uniformity of medication on Medicaid formulary tiers) be sunset per LSMS policy.
R102-22: Uniformity of medication placement on Medicaid formulary tiers Directs the LSMS to urge the Louisiana Department of Health to require that all companies administering Louisiana Medicaid plans be required to uniformly place drugs in the Medicaid formulary on a specific Tier when requiring a prior authorization. For example, drug XYZ would be on Tier 1 for all companies’ Prior Authorizations, while drug ABC might be on Tier 2 for all companies. This issue was first approved by the House in 2020 and was reaffirmed in 2022 as little to no action was taken between that time due to the COVID-19 pandemic. Since reaffirmation in 2022, the LSMS has met with LDH and shared the problems related to this issue. However, LDH squarely places the blame with the managed care organizations (MCOs) who administer the state’s Medicaid program, while the MCO’s state that they are following their contracted commitment to the state. At this time, no further action will be taken on this issue.
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