RA Messages for November 16, 1999

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   THE  8 / 15 / 98  VERSION OF  APPENDIX  A:

DRUG DOSAGE STRGTH MAC EFF.DATE
CODEINE PHOS/APAP  ELIXIR   OFF MAC 11/30/99
CYPROHEPTADINE  SYRUP 2MG/5ML OFF MAC  11/30/99
DELAVIRDINE MESYLATE  TABLET 200MG   10/26/99
ENTACAPONE  TABLET 200MG   10/22/99
GENTAMICIN SULFATE DROPS 0.3% $1.40000 11/30/99
LITHIUM CARBONATE TABLET 300MG $0.19210 11/30/99
 NAPH,MB-DB/K PH,MBDB POWDER     09/13/99
OSELTAMIVIR PHOSPHATE CAPSULE 75MG   10/28/99
PRENAT VIT/FE,CARBO/DOSS/CA/FA TABLET 90-1MG    10/12/99
 ZAFIRLUKAST  TABLET 10MG   10/18/99

PLEASE  FILE  ADJUSTMENTS  FOR  CLAIMS  WHICH  MAY  HAVE BEEN INCORRECTLY PAID.

THE UNISYS EMC DEPARTMENT IS UNDERGOING TESTING TO ENSURE THAT EMC SUBMISSIONS ARE Y2K READY.  EMC VENDORS AND SUBMITTERS WILL NOT CHANGE THE PROCESS CURRENTLY BEING USED TO SUBMIT EMC CLAIMS TO UNISYS.  ALL REQUIRED CHANGES ARE BEING MADE BY UNISYS WITHIN MMIS TO CONVERT NECESSARY DATA TO Y2K STATUS.  IF YOU RELY ON ANOTHER ENTITY (I.E., BILLING SERVICE, CLEARINGHOUSE) TO BILL CLAIMS OR RECONCILE ACCOUNTS ON YOUR BEHALF, PLEASE SHARE THIS INFORMATION WITH THEM.  IF ENTITIES ARE NOT INFORMED AND/OR NOT Y2K READY, IT MAY CAUSE DIFFICULTY FOR YOU.

NOTICE TO PROFESSIONAL PROVIDERS

CODES DISCONTINUED IN THE 1999 ISSUANCE OF THE CURRENT PROCEDURAL TERMINOLOGY WILL BE PLACED IN NON-PAY STATUS EFFECTIVE DATE OF SERVICE DECEMBER 1, 1999.

NOTICE TO PHYSICIANS AND KIDMED PROVIDERS

RE: ROTOVIRUS VACCINE (PROCEDURE CODE 90680) WYETH LEDERLE VACCINES ANNOUNCED THAT IT HAS WITHDRAWN ITS ROTASHEILD VACCINE FROM THE MARKET AND HAS REQUESTED THE IMMEDIATE RETURN OF ALL DOSES OF THE VACCINE.  THEREFORE, PROCEDURE CODE 90680 (ROTOVIRUS) IS NO LONGER PAYABLE BY LOUISIANA  MEDICAID EFFECTIVE 10/19/1999.

DHH AND UNISYS WANT TO THANK YOU FOR PROVIDING A CONSISTENT LEVEL OF EXCELLENCE IN YOUR SERVICE OF MEDICAID RECIPIENTS.  PLEASE KNOW THAT THE CLAIMS PROCESSING SYSTEM (LMMIS) IS READY FOR BUSINESS AS USUAL IN THE YEAR 2000.  WE RECOGNIZE THE BENEFIT OF BEING READY FOR POTENTIAL EMERGENCIES, CAUSED BY Y2K TECHNOLOGY FAILURES, AND THE NECESSITY OF ENSURING RECIPIENTS CONTINUE TO RECEIVE SERVICES.  WE ENCOURAGE YOU TO GET AN EARLY START ON PLANNING.  YOU MAY WISH TO CONTACT YOUR LOCAL AMERICAN RED CROSS OFFICE TO OBTAIN A COPY OF THEIR BOOKLET ON Y2K PREPAREDNESS OR VISIT THEIR INTERNET SITE.  PLEASE COMMUNICATE WITH YOUR BUSINESS PARTNERS AND CLIENTELE REGARDING YOUR Y2K READINESS.  WE WOULD APPRECIATE YOUR ASSISTANCE IN BEING A REASSURING INFORMATION VEHICLE TO HELP EASE YOUR PATIENT'S FEAR REGARDING THE CHANGEOVER TO THE NEW MILLENNIUM.

ATTENTION DENTAL PROVIDERS

UNTIL FURTHER NOTICE, PLEASE DO NOT SUBMIT THE NEW 1999 AMERICAN DENTAL ASSOCIATION (ADA) DENTAL CLAIM FORM FOR PAYMENT OF MEDICAID DENTAL CLAIMS OR FOR MEDICAID DENTAL PRIOR AUTHORIZATION DETERMINATIONS.  THESE SYSTEMS ARE CURRENTLY NOT CAPABLE OF PROCESSING THESE FORMS AND THEY WILL BE RETURNED TO YOU WITHOUT BEING PROCESSED.  WHEN THESE SYSTEMS ARE ADJUSTED TO ACCEPT THE 1999 VERSION OF THE ADA DENTAL CLAIM FORM YOU WILL BE NOTIFIED.  AT A FUTURE DATE, WE EXPECT TO MAKE THE 1999 VERSION OF THE ADA DENTAL CLAIM FORM MANDATORY FOR USE AND, AT THAT TIME, WILL BE THE ONLY DENTAL CLAIM FORM ACCEPTED FOR MEDICAID DENTAL CLAIMS PROCESSING OR DENTAL PRIOR AUTHORIZATION DETERMINATIONS.  YOU WILL BE NOTIFIED WHEN THIS CLAIM FORM BECOMES MANDATORY AND WILL BE ALLOWED A TRANSITION PERIOD IN ORDER TO ADHERE TO THIS NEW REQUIREMENT.  SHOULD YOU HAVE ANY QUESTIONS YOU MAY CONTACT UNISYS PROVIDER RELATIONS BY CALLING 1-800-473-2783 (OR 225-924-5040).