RA Messages for April 21, 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.
Please note the
following changes to Appendix A
DRUG
DOSE
STRG
FUL
EFF.
ACETYLCYSTEINE
VIAL
200MG/ML
0.26800
4/30/09
ALENDRONATE SODIUM
TABLET
5MG
0.42930
4/30/09
ALENDRONATE SODIUM
TABLET
10MG
0.42930
4/30/09
BISOPROL/HYDROCHLOROTHIAZIDE TABLET
10-6.25MG
0.25420
4/30/09
CLOBETASOL PROPIONATE
GEL,TOP
0.05%
0.46400
4/30/09
CLOBETASOL PROPIONATE
OINT,TOP
0.05%
0.19400
4/30/09
CLOBETASOL PROPIONATE
SOL,TOP
0.05%
0.42000
4/30/09
FLUOROURACIL
SOL,TOP
5%
11.68950
4/30/09
FOSINOPRIL/HYDROCHLOROTHIAZIDE TABLET
10-12.5MG
1.34540
4/30/09
FOSINOPRIL/HYDROCHLOROTHIAZIDE TABLET
20-12.5MG
1.34540
4/30/09
HYDRALAZINE HCL
TABLET
10MG
0.25560
4/30/09
HYDRALAZINE HCL
TABLET
25MG
0.32840
4/30/09
HYDRALAZINE HCL
TABLET
50MG
0.42000
4/30/09
HYDRALAZINE HCL
TABLET
100MG
0.78380
4/30/09
HYDROCHLOROTHIAZIDE
CAPSULE
12.5MG
0.12000
4/30/09
HYDROCORTISONE BUTYRATE
CR,TOP
0.10%
1.11770
4/30/09
MOEXIPRIL/HYDROCHLOROTHIAZIDE TABLET
7.5/12.5MG
1.21110
4/30/09
MOEXIPRIL/HYDROCHLOROTHIAZIDE TABLET
15/12.5MG
1.21110
4/30/09
MOEXIPRIL/HYDROCHLOROTHIAZIDE TABLET
15/25MG
1.21110
4/30/09
NYSTATIN
ORAL SUSP
100K U/ML
0.20620
4/30/09
ORPHENADRINE CITRATE
TABLET SA
100MG
1.04250
4/30/09
OXCARBAZEPINE
TABLET
150MG
0.90000
4/30/09
OXCARBAZEPINE
TABLET
300MG
1.71000
4/30/09
OXCARBAZEPINE
TABLET
600MG
3.42000
4/30/09
PERPHENAZINE
TABLET
2MG
OFF MAC 4/30/09
PERPHENAZINE
TABLET
16MG
OFF MAC 4/30/09
PILOCARPINE
TABLET
7.5MG
1.94250
4/30/09
PRAZOSIN HCL
CAPSULE
5MG
0.53700
4/30/09
PROPRANOLOL HCL
CAP.SA 24H
60MG
1.32240
4/30/09
PROPRANOLOL HCL
TABLET
60MG
0.67140
4/30/09
RISPERIDONE
TABLET
0.25MG
1.30050
4/30/09
RISPERIDONE
TABLET
0.5MG
1.42730
4/30/09
RISPERIDONE
TABLET
1MG
1.51730
4/30/09
RISPERIDONE
TABLET
2MG
2.53580
4/30/09
RISPERIDONE
TABLET
3MG
2.97830
4/30/09
RISPERIDONE
TABLET
4MG
4.00020
4/30/09
ROPINIROLE HCL
TABLET
0.25MG
0.75150
4/30/09
ROPINIROLE HCL
TABLET
0.5MG
0.75150
4/30/09
ROPINIROLE HCL
TABLET
5MG
0.77960
4/30/09
TRIAMCINOLONE ACET
CR, TOP
0.025%
0.03750
4/30/09
VENLAFAXINE HCL
TABLET
25MG
1.16580
4/30/09
VENLAFAXINE HCL
TABLET
37.5MG
1.20030
4/30/09
VENLAFAXINE HCL
TABLET
50MG
1.23660
4/30/09
VENLAFAXINE HCL
TABLET
75MG
1.31100
4/30/09
VENLAFAXINE HCL
TABLET
100MG
1.38920
4/30/09
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
PROVIDERS
For
Medicaid pharmacy services effective May 1, 2009, the Department of
Health and Hospitals, Bureau of Health Services Financing will establish
a five-prescription limit per recipient per calendar month. Please refer
to www.lamedicaid.com for detailed information.
OBSTETRICAL
ULTRASOUND POLICY CLARIFICATION
Louisiana
Medicaid's policy on obstetrical ultrasounds has been updated and
clarified. Providers submitting claims for these services are
responsible for, and expected to comply with, Medicaid policy. The
clarification is currently published on the Medicaid website homepage,
found at www.lamedicaid.com, and will also be published in an upcoming
edition of the "Louisiana Medicaid Provider Update."
ATTENTION: CDC
HEALTH ADVISORY - VACCINE SHORTAGE
The
Centers for Disease Control and Prevention (CDC) has issued a Health
Advisory Alert regarding Haemophilus influenzae Type B disease and a
documented shortage of the vaccine for this disease. Included in this
alert are recommendations from the CDC for the provision of the vaccine
during this time of vaccine shortage. A link to this important Health
Advisory Alert can be found on the homepage of the Medicaid website,
www.lamedicaid.com. Louisiana Medicaid urges all providers of pediatric
vaccines to review this information. For further information on
Haemophilus influenza Type B conjugate vaccination, please visit the
LINKS Immunization Registry at
https://linksweb.oph.dhh.louisiana.gov/linksweb/main.jsp
ATTENTION ALL
PROVIDERS
Effective
March 30, 2009, HMS assumed the responsibility of updating the TPL
Resource Files for recipients with private insurance. A new form for
reporting TPL information updates was introduced in the Spring 2008 TPL
provider training workshops. At that time, providers were given the
option to either submit the form via fax or to continue to mail the form
with the affected claims to the TPL Unit. With the transition to HMS,
providers should discontinue submitting claims with the TPL Information
Update form. Effective immediately, the update form must be FAXED to HMS
at 1-866-976-2215. An EOB or carrier letter supporting the requested
update should be included when/if available. Any claims submitted with
these requests will not be processed; they will be considered
documentation only. Processing of your requests should only take one
week. Providers should hold any and all claims until the recipient file
is updated, then submit the claims through normal processing channels.
Providers should check this information through the recipient
eligibility options, e-MEVS, MEVS, or REVS, to ensure that the update
has occurred. The new TPL form, Medicaid Recipient Insurance Information
Update, is located on the homepage of the La Medicaid website,
www.lamedicaid.com, under the
link, "TPL Information." Questions concerning updates should be
addressed to HMS at 1-866-976-2210.