RA Messages for April 28, 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
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.
ATTENTION
PROVIDERS: CHANGES IN TRANSMITTING COMMUNITYCARE PCP
REFERRAL AUTHORIZATION NUMBERS FOR EDI CLAIMS
Effective with date of
processing June 1, 2009, service providers will be required to transmit
the PCP's 10-digit NPI as the CommunityCARE Referral Authorization
Number on EDI claims transactions. A detailed provider notice,
containing important information for both PCPs and servicing providers
that must have a referral, is posted on the homepage of the LA Medicaid
website, www.lamedicaid.com. Please visit the website to obtain this
needed information in order to make all necessary changes and be
prepared for this transition to avoid unnecessary claim denials.
ATTENTION
PHARMACY PROVIDERS
Updates
to the Pharmacy Benefits Management Services Manual are now available on
the Louisiana Medicaid website at www.lamedicaid.com. Pharmacy providers
should refer to the manual for a complete description of Medicaid
pharmacy program policy.