RA Messages for January 12, 2009
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.
Detailed FUL changes
are posted on www.lamedicaid.com.
CORRECTIONS TO
APPENDIX A (dated 1/1/09)
page 49 IBUPROFEN
TABLETS, 600mg $0.41700,
eff 01/12/09
page 72 NYSTATIN/TRIAM. CR, 15mg
$0.28533, eff 05/01/04
page 72 NYSTATIN/TRIAM. CR, 30mg
$0.09750, eff 01/22/02
page 72 NYSTATIN/TRIAM. CR, 60mg
$0.18816, eff 05/01/04
page 72 NYSTATIN CR, 15mg,
30mg $0.09900, eff 01/12/09
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.
ATTENTION ALL PROVIDERS
2009 HCPCS UPDATE
Louisiana Medicaid is in the process of completing the
programming for
the 2009 HCPCS updates. This includes both new and deleted codes for
2009. Every attempt is being made to have the new codes/updates on file
by mid January 2009. Please note that all appropriate editing and coverage determinations for the new codes may not be final at that time and
adjustments to claims processed may be necessary. Providers should
monitor future RA messages.
ALL PROVIDERS
The Louisiana Legislature has funded additional New Opportunity Waiver
slots through the NOW Trust Fund. Most New Opportunity Waiver slots
filled on or after November 3, 2008 are part of the NOW Trust Fund. A
system for processing claims for recipients of this group is currently
in development. Claims for any Medicaid services provided for NOW Trust
Fund recipients of waiver slots will not be accepted until after
January 1, 2009. At that time, all claims for these recipients will be
held as "pending" with a tentative payment begin date of February 1,
2009. However, providers will be notified as soon as programming is
completed, and payment of the pending claims will move forward for final
processing at that time.
ATTENTION DENTAL PROVIDERS
Effective for dates of
service on and after December 24, 2008, changes will be imposed for the
EPSDT Dental Program including increased reimbursement for certain
procedures, revised policy regarding root canals, and coverage of five
additional procedures. Implementation of these changes may be delayed if
required programming changes are not complete; however, if this occurs,
Medicaid will recycle affected claims. Complete details will be placed
on the www.lamedicaid.com website under the "New Medicaid Information,"
"Billing Information," and "Fee Schedule" links. If you have questions,
you may contact the LSU Dental Medicaid Unit at 504-941-8206 or
1-866-263-6534 (toll-free).
ALL PROVIDERS
As a result of the bypass
for specific errors relating to Hurricane Gustav, we have identified
that some Inpatient, Outpatient, Physician, and Home Health claims were
paid erroneously. The majority of these claims paid at zero. We have
identified the claims impacted and they are being voided on this week's
Remittance Advice (1/13/09). These voided claims will need to be
reviewed for potential errors and resubmitted with the correct
information so that they can be processed. If you have questions
concerning this process, please contact Provider Relations at (800)
473-2783 or (225) 924-5040.