PLEASE NOTE THE FOLLOWING CHANGES TO APPENDIX A:

IF YOU ARE UNSURE ABOUT THE COVERAGE OF A DRUG PRODUCT, PLEASE CONTACT THE PBM HELP DESK AT 1-800-648-0790.                                   

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

BUDGET CUT RESTORATION PROCESSING ERROR

SOME PROVIDERS RECEIVED DENIED ADJUSTMENT CLAIMS WITH ERROR 799 ON THE RA DATED 03/14/06. A PROCESSING ERROR OCCURRED WHEN RESTORING EARLIER BUDGET CUTS. THE BUDGET CUT RESTORATIONS WILL BE REPROCESSED AND WILL APPEAR ON THE RA DATED 03/21/06. NO ACTION IS NEEDED BY PROVIDERS TO CORRECT THIS ERROR. 

IMPORTANT COMMUNITYCARE AND KIDMED INFORMATION

THE COMMUNITYCARE REFERRAL AND KIDMED LINKAGE AND TIMELY FILING REQUIREMENTS WERE TEMPORARILY WAIVED FOR ENROLLEES FROM THE PARISHES MOST DIRECTLY AFFECTED BY HURRICANES KATRINA AND RITA. EFFECTIVE APRIL 1, 2006, THESE WAIVERS WILL END FOR ALL COMMUNITYCARE RECIPIENTS STATEWIDE. THIS MEANS THAT IF YOU PROVIDE MEDICAL CARE ON OR AFTER APRIL 1, 2006, TO A COMMUNITYCARE ENROLLEE WHO HAS A PCP LINKAGE AS IDENTIFIED BY ANY MEDICAID ELIGIBILITY VERIFICATION SYSTEM, YOU WILL NEED A REFERRAL FROM THE PCP IN ORDER TO BE PAID BY MEDICAID. SERVICES PROVIDED TO KIDMED ENROLLEES WHO ARE NOT IN COMMUNITYCARE MUST BE PROVIDED BY THE KIDMED PROVIDER OF RECORD AND FILED WITH MEDICAID IN ACCORDANCE WITH KIDMED TIMELY FILING REQUIREMENTS. 

INPATIENT HOSPITALS AND PRIVATE PSYCHIATRIC HOSPITALS

EFFECTIVE FOR DATES OF SERVICE ON OR AFTER JANUARY 1, 2006, MEDICAID INPATIENT PER DIEM RATES WERE REDUCED IN ACCORDANCE WITH AN EMERGENCY RULE ISSUED BY THE DEPARTMENT OF HEALTH AND HOSPITALS. 

THIS ACTION WAS REPEALED ON FEBRUARY 28, 2006 FOR DATES OF SERVICE ON OR AFTER JANUARY 1, 2006 AND AFFECTED CLAIMS WERE ADJUSTED ON THE CHECK- WRITE DATE OF MARCH 7, 2006.NO ACTION IS REQUIRED OF MEDICAID PROVIDERS.