RA Messages for September 4, 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 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 ALL PROVIDERS

THE SCHEDULED DATES AND LOCATIONS FOR 2007 FALL PROVIDER WORKSHOPS FOLLOWS. THE DETAILED TRAINING SCHEDULE WILL BE AVAILABLE ON THE LAMEDICAID WEB SITE, WWW.LAMEDICAID.COM, TRAINING LINK THIS WEEK. PLEASE REVIEW THE COMPLETE SCHEDULE FOR THE DAYS/DATES OF THESE WORKSHOPS:
BATON ROUGE - SEPTEMBER 11TH, 12TH, 13TH; LAFAYETTE - SEPTEMBER 17TH, 18TH, 19TH; LAKE CHARLES - SEPTEMBER 20TH; SHREVEPORT/BOSSIER - SEPTEMBER 25TH, 26TH, 27TH; AND NEW ORLEANS - OCTOBER 2ND, 3RD, 4TH.

COMMUNITYCARE NOTICE TO ALL MEDICAID PROVIDERS

DUE TO THE EFFECTS OF HURRICANES KATRINA AND RITA, DHH SUSPENDED MANDATORY COMMUNITYCARE LINKAGES IN SOME OF THE MOST HEAVILY AFFECTED AREAS. EFFECTIVE OCTOBER 1, 2007, DHH WILL RESUME MANDATORY LINKAGES IN ORLEANS (36) AND CAMERON (12) PARISHES. COMMUNITYCARE PCPS IN THESE PARISHES SHOULD NOTICE AN INCREASE IN THE NUMBER OF COMMUNITYCARE LINKAGES ON THEIR CP-0-92 REPORT BEGINNING OCTOBER 2007. ALL PROVIDERS SHOULD BE AWARE THAT MEDICAID PATIENTS WHOM THEY HAVE BEEN TREATING MAY BECOME LINKED TO A COMMUNITYCARE PCP EFFECTIVE OCTOBER 1, 2007. IN ORDER TO BE REIMBURSED BY MEDICAID, PROVIDERS WHO ARE NOT THE PCP OF RECORD MUST HAVE A REFERRAL/AUTHORIZATION FROM THE APPROPRIATE PCP (AS REFLECTED ON THE MEDICAID ELIGIBILITY VERIFICATION SYSTEM) PRIOR TO PROVIDING SERVICES. IT IS THE MEDICAID PROVIDER'S RESPONSIBILITY TO VERIFY RECIPIENT ELIGIBILITY/COMMUNITYCARE.

DHH WANTS YOUR NPI

IF YOU HAVE NOT REGISTERED YOUR NATIONAL PROVIDER IDENTIFIER (NPI) WITH UNISYS, PLEASE DO SO IMMEDIATELY. 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 PROFESSIONAL SERVICES PROVIDERS

DHH IS PLEASED TO ANNOUNCE THAT EFFECTIVE WITH DATE OF SERVICE 7-1-2006 FORWARD, LOUISIANA MEDICAID REIMBURSES PREVENTIVE MEDICINE EVALUATION AND MANAGEMENT SERVICES FOR ADULTS, AGED 21 YEARS AND OLDER. PROVIDERS ARE TO USE THE APPROPRIATE PREVENTIVE MEDICINE CPT CODE BASED ON THE AGE OF THE RECIPIENT WHEN SUBMITTING CLAIMS FOR THESE SERVICES. ONE PREVENTIVE MEDICINE SERVICE WILL BE ALLOWED PER CALENDAR YEAR. THE PREVENTIVE MEDICINE SERVICES WILL BE INCLUDED IN THE 12 OUTPATIENT VISIT - SERVICE LIMIT ALLOWED PER CALENDAR YEAR. PROVIDERS ARE RESPONSIBLE FOR ADHERENCE TO THE ADULT PREVENTIVE MEDICINE SERVICES POLICY WHICH CAN BE LOCATED ON THE LOUISIANA MEDICAID WEBSITE AT WWW.LAMEDICAID.COM USING THE APPROPRIATE LINK ON THE HOME PAGE.

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 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 WWW.LAMEDICAID.COM UNDER THE LINK ENTITLED "NEW MEDICAID INFORMATION." IF YOU HAVE QUESTIONS, CONTACT THE MEDICAID DENTAL UNIT BY CALLING 225-216-6470.

COMMUNITYCARE NOTICE TO ALL MEDICAID PROVIDERS

EFFECTIVE NOVEMBER 5, 2007, THE UB92 FORM WILL BE DISCONTINUED AND ONLY THE UB04 FORM WILL BE ACCEPTED. WHEN USING THE UB04 OR 837I FOR CLAIMS WHICH REQUIRE A COMMUNITYCARE PCP REFERRAL/AUTHORIZATION, THE REFERRAL/AUTHORIZATION NUMBER MUST NOW BE PLACED IN LOCATOR 63C INSTEAD OF 83A. PLACING THE REFERRAL/AUTHORIZATION NUMBER IN ANY OTHER LOCATION WILL CAUSE THE CLAIM TO DENY. QUESTIONS REGARDING THE NEW UB04 FORM SHOULD BE DIRECTED TO UNISYS PROVIDER RELATIONS AT (800)473-2783.