Aetna Better Health of Louisiana Louisiana Medicaid

RXBIN: 610591

RXPCN: ADV

RXGRP: RX8834

Effective October 1, 2017, Aetna Better Health of Louisiana began reimbursing claims according to the Louisiana Medicaid Local Pharmacy Network Enrollment Form. This notice is to inform you that reimbursement for multi-source brand products submitted with a DAW 1 will change to utilize the same reimbursement methodology as single-source products (i.e., FUL will not be used in reimbursement methodology for multi-source brand products with a DAW 1) and the Network Enrollment Form for Louisiana Medicaid Local Pharmacy Network is amended to that effect.

*Please see attachment for more information.