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 LOUISIANA MEDICAID PROVIDERS:
MONTHLY PROVIDER UPDATE

In the past, the Louisiana Department of Health provided a bi-monthly provider update, which is a publication comprised of news articles related to Louisiana Medicaid. The articles consisted of Medicaid program initiatives, clarification of common provider problems, or reminders of upcoming program changes.

It has been determined that the provider update will resume as a monthly electronic publication and will be posted on lamedicaid beginning August 1, 2016.

ATTENTION FEDERALLY QUALIFIED HEALTH CENTERS:
The Process for Annual PPS Rate Adjustment Notification is Changing

In the past, each Federally Qualified Health Center (FQHC) has received an annual letter indicating the updated prospective payment system (PPS) rate for the facility. Beginning with updates for State Fiscal Year (SFY) 2017, FQHCs will no longer receive a letter notifying them of their annual PPS rate adjustment.

The Medicare Economic Index (MEI) is the determining factor for the yearly change in the PPS rate. For SFY 2017, which begins July 1, 2016, each FQHC’s current rate will increase by 1.1 percent. Updated PPS rates will be communicated to the FQHCs and others via the Medicaid published fee schedule, available on the Medicaid website (www.lamedicaid.com) under the Fee Schedules link.

If you have questions about the content of this message, you may contact Molina Provider Relations at 1-800-473-2783.

Attention Fee for Service (FFS) Louisiana Medicaid Providers:

Mosquito repellent coverage by Medicaid Pharmacy Program will be implemented when local mosquito-borne transmission of Zika virus has occurred. Please refer to http://www.lamedicaid.com/provweb1/Pharmacy/pharmacyindex.htm for more information.

Attention Fee for Service (FFS) Louisiana Medicaid Providers:

Effective July 12, 2016, the Fee for Service (FFS) Louisiana Medicaid Pharmacy Program has established clinical pre-authorization criteria for sofosbuvir/velpatasvir (Epclusa®). Please refer to http://www.lamedicaid.com/provweb1/Pharmacy/pharmacyindex.htm for more information.