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.

ATTENTION: ALL PROVIDERS BILLING MEDICAID RECIPIENTS FOR SERVICES

This message is to remind all providers that within your agreement of participation with Louisiana Medicaid you agree to accept the Medicaid payment as payment in full for services rendered to Medicaid recipients, providing for the allowances for co-payments authorized by Medicaid.

A recipient may be billed for services that have been determined as non-covered or exceeding the services limit for recipients over the age of 21. Recipients are also responsible for all services rendered after his/her eligibility has ended. Providers shall not bill recipients in instances where provider billing errors have caused a denied claim. In order to bill a recipient for a non-covered service, the recipient must be informed both verbally and in writing that he/she will be responsible for payment of the services.

NOTE: A recipient delay in receiving authorized Medicaid covered services are prohibited by Louisiana Medicaid.

ATTENTION Professionals and Hospitals Eligible for the EHR Incentive Payment Program

On May 1, 2013, Louisiana Medicaid will launch the NEW AND IMPROVED LAConnect, the online portal for eligible providers to apply for Medicaid EHR incentive payments. On May 1st, eligible professionals and hospitals will be able to access the new system via lamedicaid.com and complete the attestation process for Adoption, Implementation, or Upgrade or Meaningful Use of certified electronic health technology. To attest, go to lamedicaid.com, enter your logon credentials, and click on the LAConnect link.

ATTENTION FAMILY PLANNING PROVIDERS

Rate reductions to Family Planning services billed by Physicians and Family Planning Clinics were incorrectly applied as described below. We are systematically adjusting affected claims to correct the error. These adjustments will appear on the May 7, 2013 Remittance Advice.

PHYSICIANS

Rate reductions to Family Planning services billed by Physicians were incorrectly applied for dates of service July 1, 2012 through February 19, 2013. A 3.7 percent reduction to rates in effect on June 30, 2012 should have been applied to services rendered during this period. A reduction of 3.4 percent was applied in error.

Rate reductions to Family Planning services billed by Physicians were incorrectly applied for dates of service on or after February 20, 2013. A 3.4 percent reduction to rates in effect on June 30, 2012 should have been applied. A reduction of 3.7 percent was applied in error.

FAMILY PLANNING CLINICS

Rate reductions to Family Planning services billed by Family Planning Clinics were also incorrectly applied for dates of service on or after February 20, 2013. A 3.4 percent reduction to rates in effect on June 30, 2012 should have been applied. A reduction of 3.7 percent was applied in error.