PHARMACY PROVIDERS, PLEASE NOTE!!!

If you are unsure about the coverage of a drug product, please contact the PBM help desk at 1-800-648-0790.

Please file adjustments for claims that may have been incorrectly paid. Only those products of the manufacturers which participate in the Federal Rebate Program will be covered by the Medicaid program. Participation may be verified in Appendix C, available at http://www.lamedicaid.com/. 

Should you have any questions regarding any of the following messages, please contact Molina Medicaid Solutions at (800) 473-2783 or (225) 924-5040.

NOTICE TO ALL PHYSICIAN PROVIDERS

The Office of Population Affairs (OPA) has updated the Sterilization consent form. The new form is available on their website at http://www.hhs.gov/opa/order-publications/#pub_sterilization-pubs. You may also download a fillable PDF version from the Louisiana Medicaid Website at http://www.lamedicaid.com/provweb1/Forms/Sterilization_Consent.pdf. Providers should begin utilizing the current form effective immediately; however, the form with the expiration date effective 12/31/2012 will be authorized by the Department as an acceptable consent until April 1, 2013. Beginning with dates of service April 1, 2013 and beyond, Health Plans and Molina will only accept the Consent form with the expiration date of October 31, 2015.

Molina shall only accept the Consent form with the expiration date of October 31, 2015, beginning with dates of Service April 1, 2013. Please visit http://www.lamedicaid.com/ for the notice. If you have any questions please contact Molina Provider Relations (800)473-2783 or (225)924-5040.

Attention Physicians and Hospital Providers: Effective 1/1/2013
Changes to PA requirements for RUM

Effective January 1, 2013, prior authorization for high-end Radiology services for Legacy or Fee for Service Medicaid recipients will no longer be required. Providers should only order services that are medically necessary. Please visit http://www.lamedicaid.com/. for the notice. If you have any questions please contact Molina Provider Relations (800)473-2783 or (225)924-5040.

ATTENTION PRIMARY CARE PROVIDERS

The Affordable Care Act requires Medicaid to reimburse designated physicians for specified primary care services rendered during calendar years 2013 and 2014 at an enhanced rate. For more information on this enhanced reimbursement and what physicians must do to receive it, visit http://www.lamedicaid.com/. 

ATTENTION PROVIDERS:

Providers who submitted claims for claim type 14 and 15 for the period of 3/1/2012 forward, for those individuals who are in populations that are excluded from the LBHP program and that originally denied for edit 555 (submit claim to LBHP SMO), those claims are being recycled for either payment or denial for the correct edit by Molina on the RA of 12/18/12. We apologize for any inconvenience that this may have caused providers.

ATTENTION PROVIDERS:

Providers who submitted claims for claim types 01, 04, 14 and 15 for the period of 3/1/12 forward for those individuals who are in populations that are excluded from the LBHP program, with a diagnosis of specialized behavioral health, and that originally denied for edit 555 (submit claim to LBHP SMO), are recycled for payment by Molina on the RA of 12/10/12. We apologize for any inconvenience that this may have caused providers.

ATTENTION ALL PROVIDERS
HOLIDAY CHECKWRITE DATES ADJUSTED

Due to the State, Federal and Bank Holiday schedules, the checkwrite dates for the last week in December and the first week in January will be adjusted to Wednesday, December 26, 2012, and Wednesday, January 2, 2013. EFTs will be released on December 27th and January 3rd.

Reminder: The EDI cutoffs for these weeks are Thursday, 12/20/12, at noon for the December 26th checkwrite and Thursday, 12/27/12, at noon for the January 2nd checkwrite.