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 1/01/02 VERSION OF APPENDIX C:

PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID

ATTENTION PHARMACY PROVIDERS

PLEASE BE ADVISED THAT THE FOLLOWING NDCS ARE BILLABLE TO MEDICAID BY THE GRAM AND CANNOT BE BROKEN UP OR PARTIALLY DISPENSED:              

             63032-0021-50 LUXIG 50 - 50 GRAM CANISTER                

             63032-0031-00 OLUX 100 - 100 GRAM CANISTER               

HIPAA NOTICE

LA MEDICAID IS USING EDIFECS FOR HIPAA TESTING SERVICES FOR ELECTRONIC SUBMITTERS WHO WOULD LIKE TO BE APROVED TO SEND HIPAA COMPLIANT CLAIMS TO LA MEDICAID FOR PAYMENT.  ASK YOUR SOFTWARE VENDOR, BILLING AGENT, CLEARINGHOUSE, OR SUBMITTER TO EMAIL *HIPAAEDI@UNISYS.COM OR CALL 1-225-237-3318 TO GET ENROLLED IN OUR HIPAA TESTING SERVICE.      

ATTENTION PHARMACY AND PRESCRIBING PROVIDERS

YOU RECENTLY RECEIVED A MEMORANDUM DATED JANUARY 13, 2003 FROM DHH CONCERNING MONTHLY PRESCRIPTION LIMITS & CLINICAL DRUG INQUIRY APPLICATIONS. PAGE 2 OF THAT MEMO CONTAINED ERRORS ON DATES AT THE TOP OF THE PAGE & IN THE BODY OF PARAGRAPH 5. THESE DATES SHOULD READ JANUARY 13, 2003 & FEBRUARY 3, 2003 RESPECTIVELY. PLEASE MAKE CORRECTIONS TO YOUR MEMO, & WE APOLOGIZE FOR ANY CONFUSION THIS ERROR MAY HAVE CAUSED.   

ATTENTION WAIVER PROVIDERS

EFFECTIVE IMMEDIATELY, PLACE OF SERVICE CODE 6 IS NO LONGER ACCEPTABLE FOR PROCEDURE CODES Z0002 AND Z0011. TO PREVENT CLAIM DENIALS, PLEASE USE AN APPROPRIATE PLACE OF SERVICE CODE FOR THESE PROCEDURES. IF YOU HAVE QUESTIONS ABOUT THE APPROPRIATE POS CODES, PLEASE CONTACT UNISYS PROVIDER RELATIONS AT 1-800-473-2783. 

ATTENTION ALL PROVIDERS

THE PROVIDER ENROLLMENT UNIT HAS MOVED. THE NEW PHONE NUMBER IS:225-237-3370. THE MAILING ADDRESS REMAINS UNISYS- PROVIDER ENROLLMENT UNIT, P.O. BOX 80519, BATON ROUGE, LA 70898-0159. PLEASE MAKE NOTE OF THIS NEW CONTACT INFORMATION. 

ATTENTION ALL MENTAL HEALTH REHAB PROVIDERS

AS YOU ARE AWARE, THERE IS A 14 DAY TIME LIMIT AFTER THE END OF A PA CYCLE TO INPUT YOUR SERVICE LOGS ON UTOPIA. THERE ARE NO EXCEPTIONS TO THE RULE. YOUR AGENCY SHOULD HAVE A BACKUP PLAN TO COVER ANY PROBLEM THAT CAN ARISE. PROGRAM OPERATIONS WILL NOT OVERRIDE THIS POLICY FOR ANY REASON. 

ATTENTION ALL HOME HEALTH PROVIDERS

IN THE DECEMBER 2001 ISSUE OF THE LOUISIANA REGISTER, HEALTH STANDARDS PUBLISHED THEIR MINIMUM STANDARDS FOR HOME HEALTH AGENCIES. INCLUDED WAS A CHANGE REGARDING SUPERVISION OF AIDES. THIS CHANGE WAS INADVERTENTLY MISSED AND THE OLD STANDARD REGARDING "EVALUATION OF AIDES" WAS PRINTED ON PAGE 2 OF THE 2002 PROVIDER TRAINING MANUAL PUBLISHED FOR THE PROVIDER TRAINING SEMINARS. PLEASE MAKE NOTE OF THE FOLLOWING, WHICH IS PART OF THE MINIMUM STANDARDS AND SHOULD BE ADHERED TO: PERIODIC ON SITE SUPERVISION WITH THE HOME HEALTH AIDE PRESENT SHALL BE ESTABLISHED AS PART OF THE AGENCY'S POLICIES AND PROCEDURES. IF THE PATIENT IS RECEIVING A SKILLED SERVICE (NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, OR SPEECH-LANGUAGE PATHOLOGY), THE SUPERVISORY VISITS SHALL BE MADE TO THE PATIENT'S RESIDENCE AT LEAST ONCE EVERY TWO WEEKS (NOT TO EXCEED 20 DAYS) BY THE RN OR APPROPRIATE THERAPIST TO ASSESS RELATIONSHIPS AND DETERMINE WHETHER GOALS ARE BEING MET. IF THE PATIENT IS NOT RECEIVING SKILLED NURSING SERVICES, A RN MUST MAKE A SUPERVISORY VISIT TO THE PATIENT'S RESIDENCE AT LEAST ONCE EVERY 62 
DAYS. IN ORDER TO ENSURE THAT THE AIDE IS PROPERLY CARING FOR THE PATIENT, THE SUPERVISORY VISIT MUST OCCUR WHILE THE HOME HEALTH AIDE IS PROVIDING PATIENT CARE.