RA Messages for November 3, 2009

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 NOTE THE FOLLOWING CHANGES TO APPENDIX A

         DRUG                   DOSE        STRGTH   FUL        EFF     

 ANTIPYRINE/BENZOCAINE/GLYCER DROPS      5.4%-1.4%  OFF LMAC  20090925  

 BENZTROPINE MESYLATE         TABLET       0.5 MG  0.07470    20091026  

 BENZTROPINE MESYLATE         TABLET         1 MG  0.08480    20091026  

 BICALUTAMIDE                 TABLET        50 MG  3.48020    20091026  

 BENZTROPINE MESYLATE         TABLET         2 MG  0.12080    20091026  

 CARBAMAZEPINE                TABLET       200 MG  0.08490    20091026  

 CEPHALEXIN                   CAPSULE      250 MG  0.16500    20091026  

 CEPHALEXIN                   CAPSULE      500 MG  0.27300    20091026  

 CEPHALEXIN                   ORAL SUSP    250 MG  0.18180    20091026  

 CYCLOBENZAPRINE HCL          TABLET        10 MG  0.10350    20091026  

 CYCLOBENZAPRINE HCL          TABLET        50 MG  0.15860    20091026  

 DICLOFENAC POTASSIUM         TABLET        50 MG  0.15860    20091026  

 HYDROCHLOROTHIAZIDE          TABLET        25 MG  0.01800    20091026  

 HYDROCHLOROTHIAZIDE          TABLET        50 MG  0.0499     20091026              

 RANITIDINE HCL               SYRUP         15 MG  0.23780    20091026  

 RANITIDINE HCL               TABLET       150 MG  0.06000    20091026  

 RANITIDINE HCL               TABLET       300 MG  0.12500    20091026  

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. 

IMPORTANT NOTICE TO ALL MEDICAID PROVIDERS AND VENDORS

Due to a shortage of Louisiana Medicaid 7-digit provider numbers to enroll new providers, we will increase the availability of these numbers for assignment to newly enrolled providers by using numbers that begin with "2" as the first digit of the number. By the end of this year, LA Medicaid will convert all systems to accept 7-digit provider numbers beginning with "2". LA Medicaid provider numbers beginning with "1" will continue to be valid and accepted. Please see the homepage at our website, www.lamedicaid.com, for additional information and continue to watch RA messages and the website for definite dates of this conversion.

ATTENTION PROVIDERS

A series of EHR software demonstrations will be hosted by the Louisiana Health Care Quality Forum beginning November 3, 2009. Each software company will demonstrate how their product would handle the tasks for a test patient in a typical office visit to a primary care physician. They each will demonstrate elements of meaningful use based on the same patient information and scenario. Each participating software vendor offers a CCHIT certified product and provides basic functionality as well as pricing information related to their product, which is available to providers gathering information. Webinars are scheduled to be hosted on Nov. 3, 5, 6, 9, 11, 12, 16 and 17th. All webinars will be from 12:00-1:00 p.m. Please visit the website at http://www.lhcqf.org for additional information.

ATTENTION PROVIDERS

The Louisiana Health Care Quality Forum will be hosting an educational EHR Adoption Conference in Baton Rouge on November 5, 2009. They would like to invite everyone to come and participate in the free conference so that one can learn about different financing opportunities available for EHR adoption as well as how LHCQF can help along the way. The invitation, agenda, and registration for the conference can be found at http://www.lhcqf.org.

ATTENTION IMMUNIZATION PROVIDERS

Louisiana Medicaid has identified that claims for the administration of the H1N1 vaccine by nurse practitioners/clinical nurse specialists/ nurse midwives/physician assistants were incorrectly priced. This has been corrected and those claims that were improperly priced will be systematically adjusted on the RA of 11/03/09. No action is required by providers. Contact Provider Relations at (800) 473-2783 with any questions.

ATTENTION HOSPITAL PROVIDERS

Systematic claim adjustments related to hospital budget cuts appeared on the 10/20/09 RA. At that time, some claims denied in error with edit 774 (included in related service). The claim lines that denied in error will be systematically recycled on the RA of 11/10/09 and adjusted correctly. We apologize for any inconvenience this has caused.