Effective February 15, 2010, Louisiana Medicaid will implement a Radiology Utilization Management (RUM) program to promote the health of Medicaid recipients by ensuring appropriate utilization of Department-defined high-tech imaging studies by Medicaid providers and recipients. Medicaid has partnered with MedSolutions Inc. (MSI), to provide prior authorization, monitoring and management of medical imaging services.
Primary care and specialty care providers will be required to request prior authorization for the following non-emergency outpatient procedures:
- Magnetic Resonance (MR)
- Computed Tomography (CT)
- Nuclear Cardiac imaging
To view the RUM Announcement letter, click here.
Updated list of procedures requiring prior authorization - effective January 1, 2012
(posted November 7, 2011)
, click here.
Updated list of procedures requiring prior authorization - effective January 1, 2011
(posted December 3, 2010)
, click here.
To access the MedSolutions website click here.
Providers may locate information such as MSI's published evidence based medical standards or complete a prior authorization request on this site.
If you are not a Louisiana Medicaid Provider and wish to order a study,
click here
to visit out provider enrollment page.
Providers should continue to monitor this webpage for the most up-to-date
information regarding this program.
Changes to PA requirements for RUM, January 1, 2013
Provider Notice New CPT Codes Added to RUM Program, November 7, 2011
Provider Notice New CPT Codes Added to RUM Program, December 3, 2010
Important DHH Procedure Update, June 7, 2010
DHH Extends Timeline for Retroactive Reviews, May 5, 2010
TIPS FOR RESOLVING IMPLEMENTATION ISSUES, March 25, 2010
Important note regarding MedSolutions’ Auth Numbers: There has been an error on some MedSolutions authorizations where the case
number was incorrectly shown as the Authorization Number on approval forms.
This error occurred on authorizations issued between February 15, 2010 through
February 24, 2010. MedSolutions will be sending corrected authorizations to the
approved facility. You may also look up a patient authorization number at
www.medsolutionsonline.com. Log in with your user ID and password and search
the recipient/member ID. Please accept MedSolutions’ apology for this error
and inconvenience.
Remember, when submitting your claim to
Molina Medicaid Solutions for payment
please drop the proceeding “A” on the authorization number.
Thank you for your continued service to our State and to the Louisiana
Medicaid population.
This content was last updated on December 3rd, 2010.