RA Messages for September 18,
2007
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 NOTE THE FOLLOWING CHANGES TO
APPENDIX C:
LABELER COMPANY
BEGIN
END
30698
VALIDUS PHARMACEUTICALS
INC
10/01/07
31357
INSPIRE PHARMACEUTICALS
INC
10/01/07
59743
ALPHAGEN LABORATORIES
INC
10/01/07
64803
OXFORD PHARMACEUTICALS
SERVICES 10/01/07
65086
SANTEN
INCORPORATED
10/01/07
66346
PEDIAMED PHARMACEUTICALS
INC
10/01/07
67979
INDEVUS PHARMACEUTICALS
INC
10/01/07
68134
LASER PHARMACEUTICALS
LLC
10/01/07
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 http://www.lamedicaid.com/.
TIME IS
RUNNING OUT! REGISTER YOUR NPI
TIME IS RUNNING OUT! PLEASE TAKE THE TIME TO REGISTER YOUR NPI WITH UNISYS IF
YOU HAVE NOT PREVIOUSLY REGISTERED. THE NPI WEB REGISTRATION SITE IS ACCESSIBLE
FROM THE LIST OF APPLICATIONS IN THE SECURED PROVIDER AREA OF THE
WWW.LAMEDICAID.COM WEBSITE. PROVIDERS
MAY CHOOSE TO REGISTER THEIR NPI USING THE NPI PAPER REGISTRATION FORM LOCATED
FROM WWW.LAMEDICAID.COM>HIPAA
INFORMATION CENTER>NATIONAL PROVIDER IDENTIFIER (NPI).
ATTENTION PHARMACISTS AND PRESCRIBING
PROVIDERS
USE OF TAMPER-RESISTANT PRESCRIPTION PADS
A PROVISION IN THE U.S. TROOP READINESS, VETERANS'
HEALTH CARE, KATRINA RECOVERY AND IRAQ ACCOUNTABILITY APPROPRIATIONS ACT OF 2007
(H.R. 2206), SECTION 7002(B) REQUIRES THE USE OF TAMPER-RESISTANT PRESCRIPTION
DRUG PADS FOR WRITTEN, NON-ELECTRONIC PRESCRIPTIONS FOR MEDICAID
RECIPIENTS. THIS PROVISION IS EFFECTIVE 10-1-07. IN AN EFFORT TO
REDUCE INSTANCES OF UNAUTHORIZED, IMPROPERLY ALTERED AND COUNTERFEIT
PRESCRIPTIONS, ALL WRITTEN PRESCRIPTIONS REIMBURSED BY LOUISIANA MEDICAID ARE
SUBJECT TO THIS STATUTORY REQUIREMENT. PLEASE REFER TO http://www.lamedicaid.com/ FOR ADDITIONAL
INFORMATION ON POLICY REGARDING TAMPER-RESISTANT PRESCRIPTION PADS.
ATTENTION DENTAL PROVIDERS
ERROR CODE 515 CLAIM DENIAL SIMPLIFICATION
PROCESS
PROVIDERS SHOULD OBTAIN DETAILED INFORMATION AT
http://www.lamedicaid.com/ UNDER THE LINK
ENTITLED "NEW MEDICAID INFORMATION." IF YOU HAVE QUESTIONS, CONTACT THE MEDICAID
DENTAL UNIT BY CALLING 225-216-6470.
ATTENTION PROVIDERS
THE DEPARTMENT OF HEALTH AND HOSPITALS BUREAU OF
HEALTH SERVICES FINANCING IN CONJUNCTION WITH THE OFFICE FOR CITIZENS WITH
DEVELOPMENTAL DISABILITIES AND THE OFFICE OF AGING AND ADULT SERVICES IS
REQUIRING MANDATORY ATTENDANCE FOR ALL DIRECT SERVICE PROVIDERS (SPECIFICALLY
PERSONAL CARE SERVICE PROVIDERS, PERSONAL CARE ATTENDANTS AND SUPERVISED
INDEPENDENT LIVING PROVIDERS) TO WORKSHOP SESSIONS ON WAIVER, PROGRAM INTEGRITY
AND PERSONAL CARE SERVICES (WORKSHOP SESSIONS: 10:30-11:45 WAIVER AND CASE
MANAGEMENT, 1:00-1:45 PROGRAM INTEGRITY AND 2:00-3:30 PCS). PROVIDERS MUST SIGN
IN AND ATTEND THESE SESSIONS AT THE MANDATORY SITE ASSIGNMENT FOUND ON THE
LAMEDICAID HOME PAGE. CLICK ON MANDATORY PROVIDER TRAINING FOR DIRECT CARE
WORKERS. THIS INFO WAS ALSO DISTRIBUTED TO YOU VIA FAX OR MAIL.
ATTENTION PROVIDERS
EFFECTIVE OCTOBER 1, 2007, DIRECT CARE PROVIDERS
(WITH THE EXCEPTION OF SUPPORT COORDINATION AGENCIES AND PERSONAL EMERGENCY
RESPONSE PROVIDERS) WILL NO LONGER BE ALLOWED TO SPAN DATE BILL. FOR DATES OF
SERVICE ON OR AFTER THAT DATE, WHEN CLAIMS ARE SUBMITTED ON THE CMS 1500 OR VIA
ELECTRONIC MEDIA, PROVIDERS WILL HAVE TO LINE-ITEM CLAIMS, INDICATING A SINGLE
DATE OF SERVICE AND THE NUMBER OF UNITS PROVIDED ON THAT PARTICULAR DAY.
ATTENTION DENTAL PROVIDERS -
NOTIFICATION
ADDRESS & TELEPHONE NUMBER CHANGE FOR THE LSU DENTAL MEDICAID UNIT EFFECTIVE
IMMEDIATELY, DENTAL PROVIDERS MUST BEGIN USING THE FOLLOWING NEW ADDRESS WHEN
SUBMITTING DENTAL PRIOR AUTHORIZATION REQUESTS OR OTHER DENTAL-RELATED
CORRESPONDENCE TO THE LSU DENTAL MEDICAID UNIT: LSU DENTAL MEDICAID UNIT, P.O.
BOX 19085, NEW ORLEANS, LA 70179-9085. THE NEW TELEPHONE NUMBERS FOR THE LSU
DENTAL MEDICAID UNIT ARE AS FOLLOWS: 504-941-8206 OR 1-866-263-6534 (TOLL-FREE).
ATTENTION PROVIDERS AND ENTITIES
THE DEFICIT REDUCTION ACT OF 2005, SECTION 6032 IMPLEMENTATION. AS A CONDITION
OF PAYMENT FOR GOODS, SERVICES AND SUPPLIES PROVIDED TO RECIPIENTS OF THE
MEDICAID PROGRAM, PROVIDERS AND ENTITIES MUST COMPLY WITH THE FALSE CLAIMS ACT
EMPLOYEE TRAINING AND POLICY REQUIREMENTS IN 1902(A)(68) OF THE SOCIAL SECURITY
ACT, SET FORTH IN THAT SUBSECTION AND AS THE SECRETARY OF US DEPARTMENT OF
HEALTH AND HUMAN SERVICES MAY SPECIFY.
AS AN ENROLLED PROVIDER/ENTITY, IT IS YOUR
OBLIGATION TO INFORM ALL OF YOUR EMPLOYEES AND AFFILIATES OF THE PROVISIONS OF
THE FEDERAL FALSE CLAIMS ACT, AND ANY LOUISIANA LAWS AND/OR RULES PERTAINING TO
CIVIL OR CRIMINAL PENALTIES FOR FALSE CLAIMS AND STATEMENTS, AND WHISTLEBLOWER
PROTECTIONS UNDER SUCH LAWS AND/OR RULES. WHEN MONITORED OR AUDITED, YOU WILL BE
REQUIRED TO SHOW EVIDENCE OF COMPLIANCE WITH THIS REQUIREMENT. THIS PROVISION
REQUIRES ANY ENTITY THAT RECEIVES ANNUAL MEDICAID PAYMENTS UNDER THE STATE PLAN
OF AT LEAST $5 MILLION TO PROVIDE FEDERAL FALSE CLAIMS ACT EDUCATION TO THEIR
EMPLOYEES.