RA Messages for October 4, 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


URGENT - ATTENTION ALL VFC (VACCINES FOR CHILDREN) PROVIDERS

THE OFFICE OF PUBLIC HEALTH HAS NOTIFIED THE DEPARTMENT OF REVISED PROCEDURES FOR ORDERING VFC VACCINES. ALL VFC VACCINE ORDERS ARE TO BE 
FAXED TO JUDI GREENE AT 318-676-7560. DO NOT SEND VFC VACCINE REQUESTS OR REPORTS TO THE REGIONAL IMMUNIZATION CONSULTANTS. FOR OTHER VFC CONCERNS, CONTACT YOUR REGIONAL IMMUNIZATION CONSULTANT. CONTACT INFORMATION FOR THESE CONSULTANTS CAN BE FOUND ON THE LINKS WEBSITE MAIN PAGE AT WWW.LINKSWEB.OPH.DHH.LOUISIANA.GOV


URGENT - ALL PROVIDERS PERFORMING NEWBORN SCREENINGS (PKU)

IN THE AFTERMATH OF HURRICANE KATRINA, THE DEPARTMENT OF HEALTH AND HOSPITALS-OFFICE OF PUBLIC HEALTH'S LABORATORY IN NEW ORLEANS IS CLOSED 
INDEFINITELY. THE OFFICE OF PUBLIC HEALTH IS MAKING ARRANGEMENTS TO FORWARD THE SPECIMENS TO ANOTHER STATE'S PUBLIC HEALTH LABORATORY FOR 
ANALYSIS. UNTIL FURTHER NOTICE, ALL NEWBORN SCREENING (PKU) FILTER PAPER
SPECIMENS (LAB-10 FORM) SHOULD BE SENT TO THE SHREVEPORT OPH LABORATORY 
AT: SHREVEPORT REGIONAL LABORATORY, P.O. BOX 3561, SHREVEPORT, LA 71133.
FOR FURTHER INFORMATION CONTACT ARTHUR HAGAR AT 318-221-0859. 


ATTENTION ALL PROVIDERS

A PROVIDER MAY NOT REFUSE HEALTH CARE TO AN INDIVIDUAL COVERED BY MEDICAID BECAUSE A THIRD PARTY HAS A LEGAL OBLIGATION TO PAY FOR THE SERVICES RENDERED. SEE 42 U.S.C. 1396A(25)(D).


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. 


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 PORTABLE X-RAY PROVIDERS

EFFECTIVE WITH DATES OF SERVICE JANUARY 1, 2004, PROCEDURE CODES R0070 AND Q0092 HAVE BEEN ADDED TO THE LIST OF CODES WHICH ARE EXEMPT FROM NEEDING A COMMUNITYCARE PCP REFERRAL. QUESTIONS REGARDING THIS MESSAGE SHOULD BE DIRECTED TO THE COMMUNITYCARE PROGRAM OFFICE AT 225-342-1304.


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. 


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