RA Messages for October 11, 2005

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ATTENTION PHARMACISTS AND PRESCRIBING PROVIDERS

THE EDITS FOR PHARMACY PRIOR AUTHORIZATION (PA) WHICH WERE TEMPORARILY SUSPENDED DUE TO THE HURRICANES WILL BE REINSTATED ON OCTOBER 17, 2005. THE DRUG CATEGORIES THAT WERE REVIEWED AT THE AUGUST 17, 2005 P&T MEETING WILL BE IMPLEMENTED INTO THE PDL/PA PROCESS ON NOVEMBER 1, 2005. ALSO, THE PRESCRIPTION LIMIT THAT WAS TEMPORARILY SUSPENDED DUE TO THE HURRICANES WILL BE REINSTATED NOVEMBER 1, 2005. 

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DENTAL PROVIDERS - MEDICAID DENTAL PA TEMPORARY PHONE NUMBER

THE MEDICAID DENTAL PRIOR AUTHORIZATION UNIT HAS BEEN TEMPORARILY 
RELOCATED DUE TO HURRICANE KATRINA. THE NEW TEMPORARY TELEPHONE NUMBER 
FOR THE MEDICAID DENTAL PRIOR AUTHORIZATION UNIT IS 225-216-6470. 

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CORRECTION *******CORRECTION*******CORRECTION

ATTENTION ALL LOUISIANA MEDICAID PROVIDERS

PLEASE NOTE THAT THE PREVIOUSLY PUBLISHED TELEPHONE NUMBER WAS INCORRECT. THE NUMBER INCLUDED ON THE FOLLOWING MESSAGE IS THE CORRECT NUMBER.

EFFECTIVE IMMEDIATELY FOR THE NEXT 60 DAYS, LOUISIANA MEDICAID PROVIDERS IN THE PARISHES BELOW* WHO WERE DISPLACED AS A RESULT OF HURRICANE KATRINA AND WISH TO ESTABLISH A TEMPORARY PRACTICE, MAY DO SO WITHOUT OBTAINING AN ADDITIONAL MEDICAID ID NUMBER OR COMPLETING ADDITIONAL LOUISIANA MEDICAID OR COMMUNITYCARE ENROLLMENT DOCUMENTS. PROVIDERS MUST ADVISE LOUISIANA MEDICAID OF THEIR TEMPORARY ADDRESS AND PHONE NUMBER BY CALLING 1-800-609-3888. THEY SHOULD ALSO CALL THE SAME NUMBER TO NOTIFY LOUISIANA MEDICAID WHEN THEY MOVE BACK TO THEIR PERMANENT LOCATION, AS WELL AS TO ASK ANY QUESTIONS REGARDING THIS POLICY. 

* JEFFERSON, WASHINGTON, TANGIPAHOA, ORLEANS, ST. CHARLES, ST. JAMES, 
ST. JOHN, LAFOURCHE, TERREBONNE, ST. BERNARD, PLAQUEMINES, ST. TAMMANY 

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ATTENTION ALL COMMUNITYCARE PROVIDERS

A RECENT REVIEW OF PCPS INDICATES THAT A LARGE NUMBER OF PROVIDERS ARE ROUTINELY ADDING NEW ENROLLEES TO THEIR PANEL OUTSIDE OF THEIR ESTABLISHED PRACTICE RESTRICTIONS. FOR EXAMPLE, PCPS WITH A "CLOSED" PANEL DESIGNATION ROUTINELY CALLING THE HOTLINE TO AUTHORIZE ADDITIONAL LINKAGES; OR PCPS WHO HAVE RESTRICTED THEIR PRACTICE BY AGE ROUTINELY ADDING LINKAGES OUTSIDE OF THEIR ESTABLISHED AGE RESTRICTION. IN ACCORDANCE WITH FEDERAL GUIDELINES AND THE COMMUNITYCARE ENROLLMENT AGREEMENT (REVISED 6/04), PCPS MUST ACCEPT INDIVIDUALS IN THE ORDER IN WHICH THEY APPLY/ARE ASSIGNED, WITHIN THEIR ESTABLISHED RESTRICTIONS, SUCH AS AGE, CURRENT PRACTICE, ETC. EFFECTIVE SEPTEMBER 1, 2005, IN KEEPING WITH FEDERAL MANAGED CARE GUIDELINES, PCPS WHO ROUTINELY AUTHORIZE ADDITIONAL LINKAGES OUTSIDE OF THEIR CURRENT PRACTICE RESTRICTIONS, WILL HAVE THEIR DESIGNATION CHANGED TO AN APPROPRIATE DESIGNATION BASED ON THEIR LINKAGE PATTERNS. 

QUESTIONS REGARDING THIS MESSAGE SHOULD BE DIRECTED TO THE COMMUNITYCARE PROGRAM OFFICE AT 225-342-1304. 

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ATTENTION DENTAL PROVIDERS

NEW TEMPORARY ADDRESS FOR MEDICAID DENTAL PRIOR AUTHORIZATION REQUESTS 
EFFECTIVE OCTOBER 1, 2005 AND UNTIL FURTHER NOTICE, ALL MEDICAID DENTAL PRIOR AUTHORIZATION REQUESTS MUST BE MAILED TO THE FOLLOWING ADDRESS: LSUHSC SCHOOL OF DENTISTRY, MEDICAID DENTAL UNIT, P.O. BOX 80159, BATON ROUGE, LA 70898-0159

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ATTENTION PROVIDERS

EFFECTIVE SEPTEMBER 15, 2005, YOU MAY BILL ELECTRONICALLY FOR PROCEDURE CODE 99360 - PHYSICIAN STANDBY SERVICE. THESE CLAIMS WILL NO LONGER BE PENDED FOR MEDICAL REVIEW BUT INSTEAD WILL BE SUBJECT TO POST-PAYMENT REVIEW. 

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PROFESSIONAL SERVICES FEE SCHEDULE - CHEMOTHERAPY CODES

PROGRAMMING ISSUES HAVE BEEN IDENTIFIED THAT PREVENTED THE RECENT ADDITION OF CHEMOTHERAPY CODES FROM APPEARING ON THE UPDATED PROFESSIONAL SERVICES FEE SCHEDULE. PROVIDERS NEEDING TO VERIFY CODES AND REIMBURSEMENT MAY CONTACT UNISYS PROVIDER RELATIONS AT (800)473-2783 OR (225)924-5040 UNTIL THESE CODES APPEAR ON THE FEE SCHEDULE. 

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ATTENTION PROVIDERS OF STERILIZATION AND/OR HYSTERECTOMY PROCEDURES

HURRICANE KATRINA RELATED WAIVERS FOR STERILIZATION AND/OR HYSTERECTOMY 
PROCEDURES ARE POSTED IN DETAIL ON THE LOUISIANA MEDICAID WEBSITE @ WWW.LAMEDICAID.COM UNDER THE HURRICANE KATRINA LINK.