Louisiana Administrative Code
Title 40 - LABOR AND EMPLOYMENT
Part I - Workers' Compensation Administration
Subpart 2 - Medical Guidelines
Chapter 29 - Pharmacy Reimbursement Schedule, Billing Instruction and Maintenance Procedures
Section I-2907 - Reimbursement

A. Payment for brand-name pharmaceuticals including oral non-legend drugs will be made at the lesser of:

B. Payment for generic pharmaceuticals will be made at the lesser of:

C. The average wholesale prices (AWPs) for brand-name and generic pharmaceuticals will be the AWP listed in the most recent monthly update of the Annual Pharmacists' Reference Red Book available from:

Medical Economics Company, Inc.

680 Kinderkamack Road

Oradell, NJ 07649

Phone (800) 526-4870

D. Compounded prescriptions will be paid utilizing the same reimbursement formula as generic drugs. Please write "COMPOUND RX" directly above the RX# field on the Drug Claim Form.

E. When not in conflict with physician's orders and/or when not contrary to stop orders, medications should be dispensed in quantities sufficient to last 30 days except pharmaceuticals which could be considered "one-a-day, long-term maintenance" drugs, which may be dispensed in 100 unit dose quantities.

F. Refills will be permitted on an original prescription for a period of not more than one year from the date of such prescription, subject to applicable laws and regulations and only in accordance with the authorization of the prescribing physician.