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 A:

PLEASE MAKE THE FOLLOWING CHANGES TO APPENDIX B:

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 PROFESSIONAL SERVICES PROVIDERS

THE CLAIMS PROCESSING PROGRAMMING THAT PREVENTED PAYMENT OF EVALUATION AND MANAGEMENT CPT CODES (99201-99499) WHEN APPENDED WITH MODIFIER 24 OR MODIFIER 25 HAS BEEN CORRECTED . CLAIMS LESS THAN TWO YEARS OLD THAT INCORRECTLY DENIED HAVE BEEN RECYCLED AND WILL APPEAR ON THE REMITTANCE ADVICES DATED DECEMBER 12, 2006; DECEMBER 19, 2006; OR DECEMBER 26, 2006.

ATTENTION PROVIDERS

THE IMPLEMENTATION OF THE FORM CMS 1500 (0805) WILL BE DELAYED. PLEASE CONTINUE TO MONITOR THE WEBSITE AND RA MESSAGES FOR UPDATED INFORMATION.

ATTENTION DENTAL PROVIDERS
2006 AMERICAN DENTAL ASSOCIATION CLAIM FORM (HARDCOPY)

EFFECTIVE 01/01/07, MEDICAID WILL BEGIN ACCEPTING THE NEW 2006 AMERICAN DENTAL ASSOCIATION (ADA) CLAIM FORM FROM PROVIDERS WHO SUBMIT HARDCOPY CLAIMS TO MEDICAID FOR PRIOR AUTHORIZATION AND PAYMENT OF DENTAL SERVICES. MEDICAID WILL ALSO CONTINUE TO ACCEPT THE 2002 AND 2004 ADA CLAIM FORMS THROUGH 04/01/07. EFFECTIVE 04/02/07, THE 2006 ADA CLAIM FORM WILL BE REQUIRED WHEN SUBMITTING HARDCOPY CLAIMS TO MEDICAID AND
WILL BE THE ONLY CLAIM FORM ACCEPTED FOR PRIOR AUTHORIZATION AND PAYMENT OF DENTAL SERVICES. ADDITIONAL IMPORTANT INFORMATION ON THIS TOPIC IS LOCATED ON THE FOLLOWING WEBSITE: WWW.LAMEDICAID.COM (GO TO LINK ENTITLED "NEW MEDICAID INFORMATION" OR "BILLING INFORMATION".) PROVIDERS SHOULD CHECK THIS WEBSITE PERIODICALLY FOR NEW UPDATES.

MEDICAID IMPLANON UPDATE

LOUISIANA MEDICAID IS IN THE PROCESS OF IMPLEMENTING THE PROGRAMMING AND POLICY NECESSARY TO ADD BOTH THE CONTRACEPTIVE IMPLANT, IMPLANON, AND THE PROCEDURE CODING FOR ITS INSERTION/REMOVAL TO OUR FILES. PROVIDERS SHOULD MONITOR FUTURE RA MESSAGES FOR FURTHER INFORMATION AS TO WHEN THIS PROCESS IS COMPLETE AND CLAIMS MAY BE SUBMITTED.