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.
Billing Multiple Surgical Procedures
Providers are reminded that claims for multiple surgical procedures performed on the same date of service by
the same rendering provider must be submitted at the same time. Overpayments due to fragmenting claim
submissions are subject to review, recovery of the overpayment and additional sanctions as deemed appropriate
by Louisiana Medicaid.
For questions related to this information, please contact Molina Medicaid Solutions Provider Services at
(800)473-2783 or (225)924-5040.
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
who 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 Pharmacists and Prescribing Providers
Pharmacy claims for proton pump inhibitors for shared health plans or legacy recipients will still be subject to
maximum duration of therapy of 120 days effective July 1, 2013. Claims which exceed the maximum duration of
therapy will deny with EOB 697. To continue therapy past 120 days, MDs will need to get prior authorization.
See http://www.lamedicaid.com.