RA Messages for October 30, 2007

 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 WWW.LAMEDICAID.COM
 

ATTENTION PHARMACISTS AND PRESCRIBING PROVIDERS
 

DELAY OF TAMPER-RESISTANT PRESCRIPTION PAD POLICY

A PROVISION IN THE "U.S. TROOP READINESS, VETERANS' HEALTH CARE, KATRINA RECOVERY AND IRAQ ACCOUNTABILITY APPROPRIATIONS ACT OF 2007" (H.R. 2206) REQUIRES THE USE OF TAMPER RESISTANT PRESCRIPTION DRUG PADS FOR WRITTEN, NON-ELECTRONIC PRESCRIPTIONS FOR MEDICAID RECIPIENTS. THIS PROVISION WAS TO BE EFFECTIVE 10-1-07. HOWEVER, THE "TMA, ABSTINENCE EDUCATION AND QI PROGRAM EXTENSION ACT OF 2007" (H.R. 3668) WAS ENACTED, THUS DELAYING THE IMPLEMENTATION UNTIL APRIL 1, 2008. PLEASE REFER TO WWW.LAMEDICAID.COM FOR ADDITIONAL POLICY INFORMATION INCLUDING A RECENT FAQ REGARDING TAMPER RESISTANT PRESCRIPTION PADS.

ATTENTION ALL HOME HEALTH PROVIDERS

THE DEPARTMENT IS PLEASED TO ANNOUNCE EFFECTIVE FOR DATES OF SERVICE ON OR AFTER JULY 20, 2007, THE REIMBURSEMENT RATES FOR EXTENDED NURSING SERVICES ARE INCREASED AS FOLLOWS:
1. S9123-NURSING CARE IN THE HOME PERFORMED BY A REGISTERED NURSE (RN) IS INCREASED TO $34.00 PER HOUR.
2. S9124-NURSING CARE IN THE HOME PERFORMED BY LICENSED PRACTICAL NURSE (LPN) IS INCREASED TO $32.00 PER HOUR.
3. S9123 TT-NURSING CARE FOR MULTIPLE RECIPIENTS IN THE HOME PERFORMED BY A REGISTERED NURSE (RN) IS INCREASED TO $17.00 PER HOUR.
4. S9124 TT-NURSING CARE FOR MULTIPLE RECIPIENTS IN THE HOME PERFORMED BY LICENSED PRACTICAL NURSE (LPN) IS INCREASED TO $16.00 PER HOUR.
SHOULD YOU HAVE ANY QUESTIONS RELATED TO THIS MATTER, YOU MAY CONTACT UNISYS PROVIDER RELATIONS AT 1-800-473-2783 OR 225-924-5040.

ATTENTION MENTAL HEALTH CLINIC PROVIDERS

PROCEDURE CODE 96100 FOR PSYCHOLOGICAL TESTING IS OBSOLETE EFFECTIVE 11/01/07. ON 11/01 BILL CODE 96101 PSYCHOLOGICAL TESTING BY PSYCHOLOGIST OR PHYSICIAN. ONLY ONE PROCEDURE PER RECIPIENT PER YEAR MAY BE BILLED.

COMMUNITYCARE NOTICE TO ALL MEDICAID PROVIDERS

EFFECTIVE NOVEMBER 5, 2007, THE UB92 FORM WILL BE DISCONTINUED AND ONLY THE UB04 FORM WILL BE ACCEPTED. WHEN USING THE UB04 OR 837I FOR CLAIMS WHICH REQUIRE A COMMUNITYCARE PCP REFERRAL/AUTHORIZATION, THE REF/AUTH
NUMBER MUST NOW BE PLACED IN LOCATOR 63C INSTEAD OF 83A. PLACING THE REF/AUTH NUMBER IN ANY OTHER LOCATION WILL CAUSE THE CLAIM TO DENY. QUESTIONS REGARDING THE NEW UB04 FORM SHOULD BE DIRECTED TO UNISYS PROVIDER RELATIONS AT (800)473-2783.

ATTENTION PROVIDERS

THE NEW UB04 FORM WILL BE ACCEPTED BY LOUISIANA MEDICAID FOR ALL DATES OF SUBMISSION BEGINNING AUGUST 1, 2007, BUT WILL NOT BE MANDATED FOR USE UNTIL NOVEMBER 5, 2007. PROVIDERS WILL BE PERMITTED TO USE EITHER THE CURRENT UB92 FORM OR THE NEW UB04 FORM BEGINNING AUGUST 1, 2007 THROUGH NOVEMBER 4, 2007. EFFECTIVE NOVEMBER 5, 2007, THE UB92 FORM WILL BE DISCONTINUED AND ONLY THE NEW UB04 FORM SHALL BE USED. THIS INCLUDES ALL REBILLING OF CLAIMS EVEN THOUGH EARLIER SUBMISSIONS MAY HAVE BEEN ON THE UB92 FORM.

ATTENTION PROFESSIONAL SERVICE PROVIDERS

"PSYCHIATRIC SERVICES"


EFFECTIVE WITH DATE OF SERVICE OCTOBER 1, 2007, LOUISIANA MEDICAID REIMBURSES FOR SELECT PROCEDURE CODES SPECIFIC TO OUTPATIENT PSYCHIATRIC SERVICES. DETAILED POLICY INFORMATION WILL BE FORTHCOMING. PROVIDERS ARE ASKED TO HOLD CLAIMS FOR THESE SERVICES UNTIL NOTIFIED BY THE DEPARTMENT AS PROGRAMMING IS NOT YET COMPLETE. IT IS ANTICIPATED THAT THE SYSTEM  CHANGES WILL BE IN PLACE IN THE NEAR FUTURE. PLEASE MONITOR FUTURE RA MESSAGES WHICH WILL INFORM PROVIDERS WHEN THESE CLAIMS MAY BE SUBMITTED.
 

ATTENTION DENTAL PROVIDERS


EFFECTIVE FOR DATES OF SERVICE ON AND AFTER NOVEMBER 1, 2007, CERTAIN MEDICAID-COVERED EPSDT DENTAL, EXPANDED DENTAL SERVICES FOR PREGNANT WOMEN (EDSPW), AND ADULT DENTURE PROGRAM SERVICES WILL RECEIVE A REIMBURSEMENT RATE INCREASE; AND CERTAIN EPSDT DENTAL PROGRAM POLICY REVISIONS WILL BE IMPLEMENTED. REIMBURSEMENT MAY BE DELAYED (AND APPLIED RETROACTIVELY) DUE TO NECESSARY PROGRAMMING CHANGES. COMPLETE DETAILS WILL BE PLACED ON THE WWW.LAMEDICAID.COM WEBSITE UNDER THE "NEW MEDICAID INFORMATION" AND "FEE SCHEDULE" LINKS PRIOR TO NOVEMBER 1, 2007. IF YOU HAVE QUESTIONS, YOU MAY CONTACT THE LSU DENTAL MEDICAID UNIT AT 504-941-8206 OR 1-866-263-6534 (TOLL FREE).