RA Messages for October 18, 2005

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 MAKE THE FOLLOWING CHANGES TO APPENDIX C:

LABELER COMPANY BEGIN END
00070 AVENTIS PHARMACEUTICALS    01/01/06
10914 BRIGHTON PHARMACEUTICALS. INC. 01/01/06   
11042 ADVANCIS PHARMACEUTICAL 01/01/06  
13551 FSC LABORATORIES 01/01/06  
60999 ABG LABORATORIES    01/01/06

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 WWW.LAMEDICAID.COM

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. 

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 

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.

ATTENTION DENTAL PROVIDERS

EFFECTIVE NOVEMBER 1, 2005, CERTAIN DENTAL CODING, POLICY AND RELATED FEE REVISIONS WILL APPLY. DETAILED INFORMATION RELATED TO THESE REVISIONS IS LOCATED AT THE FOLLOWING WEBSITE: WWW.LAMEDICAID.COM UNDER THE LINK ENTITLED "NEW MEDICAID INFORMATION" AND UNDER THE HEADING OF "DENTAL PROVIDERS." IN ADDITION, THE REVISED FEE SCHEDULES FOR THE EPSDT DENTAL, ADULT DENTURE AND EXPANDED DENTAL SERVICES FOR PREGNANT WOMEN PROGRAMS ARE ALSO AVAILABLE AT THE ABOVE-REFERENCED WEBSITE UNDER THE LINK ENTITLED "FEE SCHEDULES." IF YOU DO NOT HAVE WEB ACCESS AND WISH TO REQUEST A HARDCOPY OF THE REVISED INFORMATION AND FEE SCHEDULES, YOU SHOULD CONTACT UNISYS PROVIDER RELATIONS AS SOON AS POSSIBLE BY CALLING (225)924-5040 OR TOLL-FREE @ (800)473-2783. 

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. 

ATTENTION PROVIDERS

THE 2006 ICD-9 DISEASE AND PROCEDURE CLASSIFICATION CODE UPDATE HAS BEEN COMPLETED AND WILL BE EFFECTIVE WITH DATES OF SERVICE 10/01/2005. CLAIMS WITH INVALID CODES BEARING A 10/01/2005 OR LATER DATE OF SERVICE WILL DENY. 

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.