Managed Care Pharmacy and Medical Drug Policies | Louisiana Department of Health Medicaid For Medicaid Partners Available for Public Comment Managed Care Pharmacy and Medical Drug Policies Managed Care Pharmacy and Medical Drug Policies In accordance with La. R.S. 46:460.51, et seq., prior to adopting, approving, amending, or implementing certain policies or procedures, LDH will publish the proposed policy or procedure for the purpose of soliciting public comments. For this purpose, a policy or procedure, as defined by the statute, shall mean a requirement governing the administration of managed care organizations specific to billing guidelines, medical management and utilization review guidelines, case management guidelines, claims processing guidelines and edits, grievance and appeals procedures and process, other guidelines or manuals containing pertinent information related to operations and pre-processing claims, and core benefits and services. The following table contains the LDH and managed care organization pharmacy and medical drug policies that are open for public comment. To provide feedback, please complete this form . Refer to the links below the table for archived postings and public comments. Item Number Policy/Procedure Date Posted Comment Period Closed Status Date Posted Comment Period Closed Status Status Document Links 2026-LHCC-MED-974 Epoprostenol (Flolan, Veletri) 4/8/26 5/23/26 Pending Epoprostenol (Flolan, Veletri) 2026-LHCC-MED-975 Enfortumab Vedotin-ejfv (Padcev) 4/8/26 5/23/26 Pending Enfortumab Vedotin-ejfv (Padcev) 2026-LHCC-MED-976 Verteporfin (Visudyne) 4/8/26 5/23/26 Pending Verteporfin (Visudyne) 2026-LHCC-MED-977 Trabectedin (Yondelis) 4/8/26 5/23/26 Pending Trabectedin (Yondelis) 2026-LHCC-MED-978 Avelumab (Bavencio) 4/8/26 5/23/26 Pending Avelumab (Bavencio) 2026-LHCC-MED-979 Tisagenlecleucel (Kymriah) 4/8/26 5/23/26 Pending Tisagenlecleucel (Kymriah) 2026-LHCC-MED-980 Voretigene Neparvovec-rzyl (Luxturna) 4/8/26 5/23/26 Pending Voretigene Neparvovec-rzyl (Luxturna) 2026-LHCC-MED-981 Octreotide Acetate (Sandostatin, Sandostatin LAR Depot, Bynfezia, Mycapssa) 4/8/26 5/23/26 Pending Octreotide Acetate (Sandostatin, Sandostatin LAR Depot, Bynfezia, Mycapssa) 2026-LHCC-MED-982 Toripalimab-tpzi (Loqtorzi) 4/8/26 5/23/26 Pending Toripalimab-tpzi (Loqtorzi) 2026-LHCC-MED-983 Eladocagene Exuparvovec-tneq (Kebilidi) 4/8/26 5/23/26 Pending Eladocagene Exuparvovec-tneq (Kebilidi) 2026-LHCC-MED-984 Siltuximab (Sylvant) 4/8/26 5/23/26 Pending Siltuximab (Sylvant) 2026-LHCC-MED-985 Eteclacalcetide (Parsabiv) 4/8/26 5/23/26 Pending Eteclacalcetide (Parsabiv) 2026-LHCC-MED-986 Paricalcitol Injection (Zemplar) 4/8/26 5/23/26 Pending Paricalcitol Injection (Zemplar) 2026-LHCC-MED-987 Teclistamab-cqyv (Tecvayli) 4/8/26 5/23/26 Pending Teclistamab-cqyv (Tecvayli) 2026-LHCC-MED-988 Linvoseltamab-gcpt (Lynozyfic) 4/8/26 5/23/26 Pending Linvoseltamab-gcpt (Lynozyfic) 2026-LHCC-MED-989 Burosumab-twza (Crysvita) 4/8/26 5/23/26 Pending Burosumab-twza (Crysvita) 2026-LHCC-MED-990 Ferric Derisomaltose (Monoferric) 4/8/26 5/23/26 Pending Ferric Derisomaltose (Monoferric) 2026-LHCC-MED-991 Pertuzumab (Perjeta), Pertuzumab-dpzb (Poherdy) 4/8/26 5/23/26 Pending Pertuzumab (Perjeta), Pertuzumab-dpzb (Poherdy) 2026-LHCC-MED-992 Datopotamab deruxtecan-dlnk (Datroway) 4/8/26 5/23/26 Pending Datopotamab deruxtecan-dlnk (Datroway) 2026-LHCC-MED-963 Sodium thiosulfate (Pedmark) 4/8/26 5/23/26 Pending Sodium thiosulfate (Pedmark) 2026-LHCC-MED-964 Alglucosidase Alfa (Lumizyme) 4/8/26 5/23/26 Pending Alglucosidase Alfa (Lumizyme) 2026-LHCC-MED-965 Erwinia Asparaginase (Erwinaze, Rylaze) 4/8/26 5/23/26 Pending Erwinia Asparaginase (Erwinaze, Rylaze) 2026-LHCC-MED-966 Protein C Concentrate, Human (Ceprotin) 4/8/26 5/23/26 Pending Protein C Concentrate, Human (Ceprotin) 2026-LHCC-MED-967 Cipaglucosidase alfa-atga--miglustat (Pombiliti-Opfolda) 4/8/26 5/23/26 Pending Cipaglucosidase alfa-atga--miglustat (Pombiliti-Opfolda) 2026-LHCC-MED-968 Mirvetuximab soravatansine-gynx (Elahere) 4/8/26 5/23/26 Pending Mirvetuximab soravatansine-gynx (Elahere) 2026-LHCC-MED-969 Retifanlimab-dlwr (Zynyz) 4/8/26 5/23/26 Pending Retifanlimab-dlwr (Zynyz) 2026-LHCC-MED-970 Zanidatamab-hrii (Ziihera) 4/8/26 5/23/26 Pending Zanidatamab-hrii (Ziihera) 2026-LHCC-MED-971 Zolbetuximab-clzb (Vyloy) 4/8/26 5/23/26 Pending Zolbetuximab-clzb (Vyloy) 2026-LHCC-MED-972 Antithrombin III (ATryn, Thrombate III) 4/8/26 5/23/26 Pending Antithrombin III (ATryn, Thrombate III) 2026-LHCC-MED-973 Daratumumab Daratumumab-Hyaluronidase-fihj (Darzalex, Darzalex, Faspro) 4/8/26 5/23/26 Pending Daratumumab Daratumumab-Hyaluronidase-fihj (Darzalex, Darzalex, Faspro) 2026-LHCC-MED-948 Afamelanotide (Scenesse) 3/18/26 5/2/26 Pending Afamelanotide (Scenesse) 2026-LHCC-MED-949 Brolucizumab-dbll (Beovu) 3/18/26 5/2/26 Pending Brolucizumab-dbll (Beovu) 2026-LHCC-MED-950 Avalglucosidase Alfa-ngpt (Nexviazyme) 3/18/26 5/2/26 Pending Avalglucosidase Alfa-ngpt (Nexviazyme) 2026-LHCC-MED-951 Margetuximab-cmkb (Margenza) 3/18/26 5/2/26 Pending Margetuximab-cmkb (Margenza) 2026-LHCC-MED-952 Naxitamab-gqgk (Danyelza) 3/18/26 5/2/26 Pending Naxitamab-gqgk (Danyelza) 2026-LHCC-MED-953 Ropeginterferon Alfa-2b-njft (BESREMi) 3/18/26 5/2/26 Pending Ropeginterferon Alfa-2b-njft (BESREMi) 2026-LHCC-MED-954 Sirolimus Protein-Bound Particles (Fyarro) 3/18/26 5/2/26 Pending Sirolimus Protein-Bound Particles (Fyarro) 2026-LHCC-MED-955 Interferon Gamma-1b (Actimmune) 3/18/26 5/2/26 Pending Interferon Gamma-1b (Actimmune) 2026-LHCC-MED-956 Faricimab-svoa (Vabysmo) 3/18/26 5/2/26 Pending Faricimab-svoa (Vabysmo) 2026-LHCC-MED-957 Alpha1-Proteinase Inhibitors (Aralast NP, Glassia, Prolastin-C, Zemaira) 3/18/26 5/2/26 Pending Alpha1-Proteinase Inhibitors (Aralast NP, Glassia, Prolastin-C, Zemaira) 2026-LHCC-MED-958 Zilucoplan (Zilbrysq) 3/18/26 5/2/26 Pending Zilucoplan (Zilbrysq) 2026-LHCC-MED-959 Ferric Carboxymaltose (Injectafer) 3/18/26 5/2/26 Pending Ferric Carboxymaltose (Injectafer) 2026-LHCC-MED-960 Bortezomib (Velcade) 3/18/26 5/2/26 Pending Bortezomib (Velcade) 2026-LHCC-MED-961 Cosibelimab-Ipdl (Unloxcyt) 3/18/26 5/2/26 Pending Cosibelimab-Ipdl (Unloxcyt) 2026-LHCC-MED-962 Zenocutuzumab-zbco (Bizengri) 3/18/26 5/2/26 Pending Zenocutuzumab-zbco (Bizengri) 2026-LHCC-MED-944 Lisocabtagene Maraleucel (Breyanzi) 3/18/26 5/2/26 Pending Lisocabtagene Maraleucel (Breyanzi) 2026-LHCC-MED-945 Lifileucel (Amtagvi) 3/18/26 5/2/26 Pending Lifileucel (Amtagvi) 2026-LHCC-MED-946 Obecabtagene autoleucel (Aucatzyl) 3/18/26 5/2/26 Pending Obecabtagene autoleucel (Aucatzyl) 2026-LHCC-MED-947 Axicabtagene ciloleucel (Yescarta) 3/18/26 5/2/26 Pending Axicabtagene ciloleucel (Yescarta) 2026-LHCC-MED-939 Aflibercept (Eylea, Eylea HD) and Biosimilars) 3/17/26 5/1/26 Pending Aflibercept (Eylea, Eylea HD) and Biosimilars) 2026-LHCC-MED-940 Mosunetuzumab-axgb (Lunsumio) 3/17/26 5/1/26 Pending Mosunetuzumab-axgb (Lunsumio) 2026-LHCC-MED-941 Hemin (Panhematin) 3/17/26 5/1/26 Pending Hemin (Panhematin) 2026-LHCC-MED-942 Emapalumab-lzsg (Gamifant) 3/17/26 5/1/26 Pending Emapalumab-lzsg (Gamifant) 2026-LHCC-MED-943 Pembrolizumab, Pembrolizumab-Berahyaluronidase Alfa-pmph (Keytruda, Keytruda Qlex) 3/17/26 5/1/26 Pending Pembrolizumab, Pembrolizumab-Berahyaluronidase Alfa-pmph (Keytruda, Keytruda Qlex) 2026-HB-MED-666 Aliqopa (copanlisib) 3/12/26 4/26/26 Pending Aliqopa (copanlisib) 2026-HB-MED-667 Tecartus (brexucabtagene autoleucel) 3/12/26 4/26/26 Pending Tecartus (brexucabtagene autoleucel) 2026-HB-MED-668 Besremi (ropeginterferon alfa-2b-njft) 3/12/26 4/26/26 Pending Besremi (ropeginterferon alfa-2b-njft) 2026-HB-MED-670 Tecvayli (teclistamab-cqyv) 3/12/26 4/26/26 Pending Tecvayli (teclistamab-cqyv) 2026-HB-MED-671 Imjudo (tremelimumab-actl) 3/12/26 4/26/26 Pending Imjudo (tremelimumab-actl) 2026-HB-MED-672 Talvey (talquetamab-tgvs) 3/12/26 4/26/26 Pending Talvey (talquetamab-tgvs) 2026-HB-MED-673 Loqtorzi (toripalimab-tpzi) 3/12/26 4/26/26 Pending Loqtorzi (toripalimab-tpzi) 2026-HB-MED-674 Aucatzyl (obecabtagene autoleucel) 3/12/26 4/26/26 Pending Aucatzyl (obecabtagene autoleucel) 2026-HB-MED-675 Ziihera (zanidatamab-hrii) 3/12/26 4/26/26 Pending Ziihera (zanidatamab-hrii) 2026-HB-MED-656 Forzinity (elamipretide) 3/12/26 4/26/26 Pending Forzinity (elamipretide) 2026-HB-MED-657 Ethyol (amifostine) 3/12/26 4/26/26 Pending Ethyol (amifostine) 2026-HB-MED-658 Fyarro (sirolimus albumin bound) 3/12/26 4/26/26 Pending Fyarro (sirolimus albumin bound) 2026-HB-MED-659 Elrexfio (elranatamab-bcmm) 3/12/26 4/26/26 Pending Elrexfio (elranatamab-bcmm) 2026-HB-MED-660 Radicava (edaravone) 3/12/26 4/26/26 Pending Radicava (edaravone) 2026-HB-MED-661 Vascular Endothelial Growth Factor (VEGF) Inhibitors 3/12/26 4/26/26 Pending Vascular Endothelial Growth Factor (VEGF) Inhibitors 2026-HB-MED-662 Alpha-1 Proteinase Inhibitor Therapy 3/12/26 4/26/26 Pending Alpha-1 Proteinase Inhibitor Therapy 2026-HB-MED-663 Bendamustine agents 3/12/26 4/26/26 Pending Bendamustine agents 2026-HB-MED-664 Kyprolis (carfilzomib) 3/12/26 4/26/26 Pending Kyprolis (carfilzomib) 2026-HB-MED-665 Keytruda (pembrolizumab) 3/12/26 4/26/26 Pending Keytruda (pembrolizumab) 2026-LHCC-MED-927 Ibandronate Injection (Boniva) 3/5/26 4/19/26 Pending Ibandronate Injection (Boniva) 2026-LHCC-MED-928 Panitumumab (Vectibix) 3/5/26 4/19/26 Pending Panitumumab (Vectibix) 2026-LHCC-MED-929 Durvalumab (Imfinzi) 3/5/26 4/19/26 Pending Durvalumab (Imfinzi) 2026-LHCC-MED-930 Tislelizumab-jsgr (Tevimbra) 3/5/26 4/19/26 Pending Tislelizumab-jsgr (Tevimbra) 2026-LHCC-MED-931 Cetuximab (Erbitux) 3/5/26 4/19/26 Pending Cetuximab (Erbitux) 2026-LHCC-MED-932 Inotersen (Tegsedi) 3/5/26 4/19/26 Pending Inotersen (Tegsedi) 2026-LHCC-MED-933 Agalsidase Beta (Fabrazyme) 3/5/26 4/19/26 Pending Agalsidase Beta (Fabrazyme) 2026-LHCC-MED-934 Bevacizumab (Alymsys, Avastin, Avzivi, Jobevne, Mvasi, Vegzelma, Zirabev) 3/5/26 4/19/26 Pending Bevacizumab (Alymsys, Avastin, Avzivi, Jobevne, Mvasi, Vegzelma, Zirabev) 2026-LHCC-MED-935 Epcoritamab-bysp (Epkinly) 3/5/26 4/19/26 Pending Epcoritamab-bysp (Epkinly) 2026-LHCC-MED-936 Ferumoxytol (Feraheme) 3/5/26 4/19/26 Pending Ferumoxytol (Feraheme) 2026-LHCC-MED-937 Off-Label Use 3/5/26 4/19/26 Pending Off-Label Use 2026-LHCC-MED-938 No Coverage Criteria 3/5/26 4/19/26 Pending No Coverage Criteria 2026-LHCC-MED-924 Hyaluronate Derivatives 3/4/26 4/18/26 Pending Hyaluronate Derivatives 2026-LHCC-MED-925 Mitomycin Instillation Solution (Jelmyto, Zusduri) 3/4/26 4/18/26 Pending Mitomycin Instillation Solution (Jelmyto, Zusduri) 2026-LHCC-MED-926 Nipocalimab-aahu (Imaavy) 3/4/26 4/18/26 Pending Nipocalimab-aahu (Imaavy) 2026-LHCC-MED-918 Elotuzumab (Empliciti) 3/4/26 4/18/26 Pending Elotuzumab (Empliciti) 2026-LHCC-MED-919 Tarlatamab-dlle (Imdelltra) 3/4/26 4/18/26 Pending Tarlatamab-dlle (Imdelltra) 2026-LHCC-MED-920 Parathyroid hormone (Natpara) 3/4/26 4/18/26 Pending Parathyroid hormone (Natpara) 2026-LHCC-MED-921 Trofinetide (Daybue, Daybue Stix) 3/4/26 4/18/26 Pending Trofinetide (Daybue, Daybue Stix) 2026-LHCC-MED-922 Idecabtagene Vicleucel (Abecma) 3/4/26 4/18/26 Pending Idecabtagene Vicleucel (Abecma) 2026-LHCC-MED-923 Afamitresgene Autoleucel (Tecelra) 3/4/26 4/18/26 Pending Afamitresgene Autoleucel (Tecelra) Related Information Previously posted for public comment Managed Care Pharmacy and Medical Drug Policies - Archive (2025) Managed Care Pharmacy and Medical Drug Policies - Archive (2024) Managed Care Pharmacy and Medical Drug Policies - Archive (2023) Managed Care Pharmacy and Medical Drug Policies - Archive (2022) Managed Care Pharmacy and Medical Drug Policies - Archive (2021 and prior) Public comments submitted Surgeon General Evelyn Griffin, MD Secretary Bruce D. Greenstein Cicero Government