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
www.lamedicaid.com.
IMPORTANT UPDATE ON NCPDP D.0 AND 5010
270/271 TRANSACTIONS
IMPLEMENTATION EFFECTIVE JANUARY 1, 2012
A reminder that effective January 1, 2012, all
electronic billings from Louisiana Medicaid pharmacy providers must be
conducted using the HIPAA NCPDP D.0 version of the transaction
standards. Pharmacy Point of Sale claims that are submitted in the NCPDP
5.1 format will be denied if received after 12/31/11 at 11:40 PM.
The Point of Sale system will be down from approximately 11:45 PM CST on
12/31/11 until 7:00 AM CST on 1/1/12 for the system changes to be
implemented. We will bring the system up earlier if the implementation
and monitoring of the changes require less time.
The MEVS (eligibility verification system) will be down for
approximately 30 minutes beginning at 11:45 PM CST on 12/31/11.
Recipient eligibility can be verified using MEVS, eMEVS, or REVS
beginning approximately 12:15 AM on 1/1/12.