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Prior authorization resources

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.

Medicaid doctor reviews documents

Services and physician-administered drugs that require prior authorization

Providers should review the Louisiana Medicaid Prior Authorization List online at The Louisiana Medicaid Prior Authorization List describes services and medications that are commonly reviewed and may require additional clinical information. Medications include those delivered in the physician’s office, clinic, and outpatient or home setting.

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 Magellan Medicaid Administration Pharmacy Benefits Manager. 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

Providers can find pharmacy prior authorization fax forms from LDH, PDF or by calling 1-800-424-1664, 24 hours a day, 7 days a week.

Physician-administered drug prior authorization

Visit for details on how to submit a prior authorization request for physician-administered drugs.

Get more information about prior authorization

Learn more about prior authorization in the Humana Healthy Horizons in Louisiana Provider Manual, PDF.

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