PHARMACY PROVIDERS, PLEASE NOTE!!! 

 PLEASE NOTE THE FOLLOWING CHANGES TO APPENDIX B:    

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.

ATTENTION PROVIDERS AND SUBMITTERS OF ELECTRONIC CLAIMS

THE DEADLINE FOR RECEIVING 2005 AND 2006 ANNUAL CERTIFICATION FORMS HAS PASSED. IF YOU HAVE NOT SUBMITTED A CERTIFICATION FORM FOR YOU SUBMITTER NUMBER (BEGINNING WITH 450), IMMEDIATE ACTION IS REQUIRED. FAILURE TO SUBMIT THE REQUIRED FORM WILL RESULT IN DEACTIVATION OF THE SUBMITTER NUMBER. IF A NUMBER IS DEACTIVATED, THE CERTIFICATION FORM WILL HAVE TO BE RECEIVED IN THE UNISYS EDI DEPARTMENT HARDCOPY (NO FAXES) BEFORE THE NUMBER IS REACTIVATED. THIS WILL RESULT IN A DELAY IN PAYMENT FOR YOUR PROVIDERS. PROVIDERS SHOULD VERIFY WITH THEIR SUBMITTER THAT THIS REQUIREMENT HAS BEEN MET TO ENSURE NO DELAYS IN CLAIMS PAYMENT. 

STERILIZATION CONSENT CLARIFICATION

IN ORDER TO FACILITATE CORRECT SUBMISSION OF THE STERILIZATION CONSENT WHEN A PREMATURE DELIVERY OCCURS, THE FOLLOWING CLARIFICATION IS PROVIDED. "PREMATURITY" IS DEFINED AS THE STATE OF AN INFANT BORN PRIOR TO THE 37TH WEEK OF GESTATION. PHYSICIANS SHOULD USE THIS DEFINITION IN THE COMPLETION OF THE STERILIZATION CONSENT WHEN PREMATURE DELIVERY IS A FACTOR. 

ATTENTION WAIVER SERVICE PROVIDERS AND SUPPORT COORDINATORS:

POLICY/PROCEDURES CHANGES ISSUED SEPTEMBER 9, 2005 IN RESPONSE TO HURRICANE KATRINA EXPIRE FEBRUARY 28, 2006. THREE OF THE CHANGES ARE BEING EXTENDED, SUBJECT TO CERTAIN REQUIREMENTS, FOR PROVIDERS STILL AFFECTED BY KATRINA. PLEASE REFER TO THE FOLLOWING WEBSITE: HTTP://WWW.LAMEDICAID.COM/PROVWEB1/KATRINA/WAIVERSERVICES.PDF 

ATTENTION ALL MEDICAID PROVIDERS

THE BUDGET CUTS WHICH WERE EFFECTIVE WITH DATES OF SERVICE BEGINNING 1/1/2006 THAT REDUCED THE MEDICAID REIMBURSEMENT RATES FOR THE FOLLOWING SERVICES: ADULT DENTURES SERVICES, ANESTHESIA SERVICES PERFORMED BY CERTIFIED REGISTERED NURSE ANESTHETISTS, DURABLE MEDICAL EQUIPMENT AND SUPPLIES, DENTAL SERVICES FOR CHILDREN, EXPANDED DENTAL SERVICES FOR PREGNANT WOMEN, HOME HEALTH SERVICES, HEMODIALYSIS SERVICES, HOSPICE SERVICES, INPATIENT HOSPITAL SERVICES, INPATIENT PSYCHIATRIC SERVICES, INTERMEDIATE CARE FACILITY SERVICES FOR THE MENTALLY RETARDED, LABORATORY AND X-RAY SERVICES, MENTAL HEALTH REHABILITATION SERVICES, NON-EMERGENCY AMBULANCE SERVICES, NURSING FACILITY SERVICES, OUTPATIENT HOSPITAL SERVICES, PHYSICIAN SERVICES, AND TARGETED CASE MANAGEMENT SERVICES ARE BEING RESTORED. THE PROCESS TO ADJUST AFFECTED CLAIMS FOR DATES OF SERVICE ON OR AFTER JANUARY 1, 2006 AND ISSUE THE PAYMENT BALANCE OWED TO THE PROVIDERS SHOULD BE COMPLETED BY MID MARCH, 2006. PROVIDERS OF THE ABOVE-REFERENCED SERVICES ARE NOT REQUIRED TO ADJUST OR VOID CLAIMS IN ORDER TO RECEIVE THE CORRECT PAYMENT AMOUNT. THESE TRANSACTIONS WILL APPEAR ON YOUR REMITTANCE ADVICE. IF YOU HAVE ANY QUESTIONS YOU MAY CALL PROVIDER RELATIONS AT 225-924-5040 OR 1-800-473-2783.