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 PHARMACISTS

THE DEPT. OF HEALTH AND HOSPITALS, BUREAU OF HEALTH SERVICES FINANCING IS REPEALING THE FEB. 20, 2006 RULE THAT CHANGED THE REIMBURSEMENT RATE FOR ANTIHEMOPHELIA DRUGS, TO AWP-30%. THE REIMBURSEMENT METHODOLOGY PRIOR TO THIS FEB. 20, 2006 RULE WILL NOW APPLY TO ALL PHARMACY PROVIDERS. DHH WILL RECYCLE CLAIMS FOR ANTIHEMOPHELIA DRUGS FOR ALL PHARMACY PROVIDERS EXCEPT 340B PHARMACY PROVIDERS. THEREFORE, PHARMACY PROVIDERS THAT ARE NOT 340 B PROVIDERS DO NOT HAVE TO RE-SUBMIT THESE CLAIMS FOR PROCESSING. HOWEVER, 340-B PROVIDERS MUST RE-SUBMIT THESE CLAIMS FOR ACTUAL ACQUISITION COST + $8.10. THE LA. MEDICAID PHARMACY BENEFITS MANAGEMENT PROVIDER MANUAL WILL BE UPDATED TO REFLECT THIS CHANGE. 

ATTENTION ALL PROVIDERS - NATIONAL PROVIDER IDENTIFIER

DHH HAS LAUNCHED A NEW NPI WEB REGISTRATION SITE FOR PROVIDERS TO REGISTER THEIR NPI WITH LOUISIANA MEDICAID. CMS WILL REQUIRE ALL HIPAA STANDARD TRANSACTIONS, INCLUDING MEVS ELIGIBILITY INQUIRY AND CLAIMS STATUS INQUIRY TO BE SUBMITTED USING THE NPI NUMBER BEGINNING 23-MAY-07.THE NEW NPI APPLICATION IS ACCESSIBLE FROM THE LIST OF APPLICATIONS IN THE SECURED PROVIDER AREA OF THE WWW.LAMEDICAID.COM WEB SITE. FIND THIS AND MORE ON THE NPI INFORMATION PAGE ACCESSIBLE FROM WWW.LAMEDICAID.COM>HIPAA INFORMATION CENTER>NATIONAL PROVIDER IDENTIFIER (NPI).

ATTENTION UCC PROVIDERS:

BEGINNING AUGUST 1, 2006 YOU CAN START SUBMITTING ADJUSTMENTS, VOIDS AND RESUBMITS OF DENIED CLAIMS. YOU WILL HAVE UNTIL SEPTEMBER 15, 2006 AT MIDNIGHT TO COMPLETE THE ABOVE REFERENCED TRANSACTIONS. THESE MAY BE SUBMITTED USING THE UCC WEB APPLICATION ONLY. NO PAYMENTS WILL BE MADE AFTER SEPTEMBER 30, 2006. REFERENCE THE UCC WEB USER GUIDE FOR INSTRUCTIONS AT 
<HTTP://WWW.LAMEDICAID.COM/PROVWEB1/HURRICANERELIEFPOOLPLAN.HTM>

ATTENTION MEDICAID PROVIDERS

ACT 816 OF THE 2006 REGULAR LEGISLATIVE SESSION REQUIRES A SECURITY CHECK PRIOR TO MAKING AN OFFER TO EMPLOY OR TO CONTRACT WITH ALL NON- LICENSED PERSONNEL OR LICENSED AMBULANCE PERSONNEL WHO PROVIDE NURSING CARE, HEALTH RELATED SERVICES, MEDIC SERVICES, OR SUPPORTIVE ASSISTANCE TO ANY INDIVIDUAL. EFFECTIVE AUGUST 15, 2006, THE BILL REQUIRES THAT IN ADDITION TO CRIMINAL HISTORY CHECKS FOR EMPLOYEES, ALL PROVIDERS MUST CHECK THE NATIONAL SEX OFFENDER PUBLIC REGISTRY. 

THE PROVIDER CAN COMPLETE THE SEX OFFENDER CHECK BY ACCESSING THE NATIONAL SEX OFFENDER PUBLIC REGISTRY WEBSITE AT HTTP:/WWW.NSOPR.GOV. THE RECORD OF THE SECURITY CHECK SHOULD BE PRINTED AND MAINTAINED IN THE PERSON'S PERSONNEL FILE.