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.

For information regarding the medication policy and/or criteria associated with this denial, providers may access the Louisiana Medicaid Preferred Drug List (PDL) / Non-Preferred Drug List at http://ldh.la.gov/assets/HealthyLa/Pharmacy/PDL.pdf.

Attention Federally Qualified Health Centers (FQHC)
and Rural Health Clinic (RHC) Providers

LDH has received confirmation from the Centers of Medicaid and Medicare Services that state Medicaid programs can consider behavioral health services provided by Licensed Professional Counselors and Licensed Marriage and Family Therapist as “other” ambulatory services in a RHC or FQHC facility. Provider manual and systems changes will be published to allow reimbursement to these providers in a RHC or FQHC setting. This change will be retroactively effective 4/1/2019.

All FQHC and RHC providers should review the Informational Bulletin at http://www.ldh.la.gov/index.cfm/page/1198 for additional information regarding this change.

Information regarding this change is forthcoming and will be located on www.lamedicaid.com under the Provider Manuals link, within the FQHC and RHC Provider manual.

Questions regarding this notice and fee for service claims should be directed to DXC Technology Provider Relations at (800) 473‐2783 or (225) 924‐5040.

Attention Louisiana Medicaid Providers:

Effective October 1, 2019, Fee for Service (FFS) Medicaid and Managed Care Organizations (MCOs) will implement updated clinical edits for opioids and antipsychotic agents. Please refer to www.lamedicaid.com under pharmacy and prescribing providers to access the document.

ATTENTION ALL MANAGED CARE ENTITIES
END-OF-TIME DATE CONVERSION FROM 12/31/2020 TO 12/31/2050

LDH Medicaid and DXC would like to announce that file end-of time dates will be converting from 12/31/2020 to 12/31/2050. DXC will convert end-of-time date on recipient eligibility and TPL data. DXC is working with Maximus to test these changes in their processes, including the 834 file process. DXC will alter the TPL file to use an end-of-time date of 12/31/2050 and will send test files to the plans. For Provider registry, DXC will convert 12/31/2020 to 12/31/2050 as an end-of-time date and will test with the plans.

If there are any questions regarding this message, please contact DXC Provider Relations at (800) 473-2783.