PHARMACY PROVIDERS PLEASE NOTE!!!

PLEASE MAKE THE FOLLOWING CHANGES TO APPENDIX A:  

EARLIER CHANGES TO APPENDICES A AND C ARE POSTED ON WWW.LAMEDICAID.COM.

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.

ALL MEDICAID PROVIDERS

THE 2006 ANNUAL TRAINING WORKSHOPS WILL BEGIN ON APRIL 24, 2006 AND RUN THROUGH MAY 24, 2006. THE DETAILED TRAINING SCHEDULE IS AVAILABLE ON THE LA MEDICAID WEB SITE, WWW.LAMEDICAID.COM, AND IN THE UPCOMING PROVIDER NEWSLETTER. PLEASE ACCESS THESE SOURCES FOR DETAILS. 

BATON ROUGE    APRIL 24-26, 2006         MONROE            MAY 11-12, 2006 
HOUMA                 MAY 1-3, 2006               ALEXANDRIA    MAY 16-18, 2006 
LAKE CHARLES   MAY 4-5, 2006               LAFAYETTE       MAY 22-24, 2006 
SHREVEPORT       MAY 8-10, 2006

ATTENTION PHARMACY PROVIDERS

AS A RESULT OF A CLAIMS PROCESSING ERROR THAT OCCURRED THE WEEK OF 6/21/05 THERE WERE DUPLICATE PAYMENTS ON THE 6/21/05 RA. MOST OF THESE DUPLICATE PAYMENTS WERE RECOUPED IN THE 6/28/05 RA. WE HAVE COMPLETED THE RESEARCH AND IDENTIFICATION OF SOME REMAINING DUPLICATE PAID PHARMACY CLAIMS AND THESE WILL BE RECOUPED ON THE RA DATED 4/11/06. 

ATTENTION DENTAL PROVIDERS

EFFECTIVE 2/17/06, THE DENTAL REIMBURSEMENT RATES THAT WERE REDUCED DUE TO A BUDGET CUT WERE RESTORED RETROACTIVE TO 1/1/06. ALL DENTAL CLAIMS FOR DATES OF SERVICE 1/1/06 - 2/16/06, THAT WERE BILLED AT HIGHER THAN THE REDUCED MEDICAID RATE, WILL BE AUTOMATICALLY ADJUSTED BY MEDICAID. THE ADJUSTED CLAIMS WILL APPEAR ON THE RA DATED 4/11/06. PROVIDERS WILL BE RESPONSIBLE FOR CLAIM CORRECTIONS IF THEY BILLED AT THE REDUCED MEDICAID RATES INSTEAD OF THEIR USUAL AND CUSTOMARY FEE, AS REQUIRED BY MEDICAID. IF THERE ARE ANY PROVIDERS WHO BILLED AT THE REDUCED MEDICAID RATES RATHER THAN THEIR USUAL AND CUSTOMARY FEES, AND A CLAIM CORRECTION IS NECESSARY, THE PROVIDER MUST CONTACT THE DENTAL MEDICAID UNIT AT 225-216-6470 FOR FURTHER INSTRUCTIONS PRIOR TO REFILING THE CLAIM. 

ATTENTION PHYSICIANS, DME, AND PHARMACY PROVIDERS

THIS IS TO ADVISE THAT DISPOSABLE INCONTINENCE PRODUCTS (DIAPERS, PULL- UPS, LINERS, AND GUARDS) ARE COVERED FOR ELIGIBLES AGE 4 THROUGH 20 YEARS OF AGE BASED ON MEDICAL NECESSITY CRITERIA IN THE DME PROGRAM. CRITERIA TO ESTABLISH MEDICAL NECESSITY IS AVAILABLE VIA THE WEBSITE WWW.LAMEDICAID.COM UNDER THE "NEW MEDICAID INFORMATION" LINK. IF YOU HAVE ANY QUESTIONS, YOU MAY CONTACT UNISYS PROVIDER RELATIONS AT 1-800-473-2783.