Humana Healthy Horizons® in Louisiana members may see any participating network provider, including specialists and inpatient hospitals. Humana Healthy Horizons does not require referrals from primary care physicians (PCPs) to see participating specialists; however, prior authorization must be obtained to see nonparticipating providers. Members may self-refer to any participating provider. PCPs do not need to arrange or approve these services for members, as long as applicable benefit limits have not been exhausted.
Services and physician-administered drugs that require prior authorization
Providers should review the Louisiana Medicaid Prior Authorization List online at
Pharmacy prior authorization
The process by which medication is supplied by a pharmacy and billed through the pharmacy benefit includes medication prior authorization (PA), quantity limits, and medication exceptions.
Prior authorizations are obtained through Prime Therapeutics State Government Solutions. Prior authorizations can be requested by phone, fax, mail, or electronic submission:
- Phone submissions: 1-800-424-1664
- Faxed submissions: 1-800-424-7402
- Electronic submissions:
CoverMyMeds
Physician-administered drug prior authorization
Visit
Get more information about prior authorization
Learn more about prior authorization in the
Louisiana Medicaid
Humana Healthy Horizons in Louisiana Availity Behavioral health Behavioral health toolkit Claims and payments Clinical coverage policies Clinical support Communications and network notices Compliance requirements Contact us Documents and forms External medical review Join our network Pharmacy - Prior authorization
Resources Training materials Webinars and resources