PHARMACY PROVIDERS, PLEASE
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 http://www.lamedicaid.com/.
Should you have any questions
regarding any of the following messages, please contact Molina Medicaid
Solutions at (800) 473-2783 or (225) 924-5040.
TO ALL DME PROVIDERS
Providers will no longer use the miscellaneous HCPC E1399 for cough stimulating device when requesting prior authorization for this equipment.
Providers may submit any outstanding claims with existing prior authorizations using the E1399 for payment; however effective immediately,
request for these services must be submitted using the appropriate code.
The appropriate code E0482 has been added to the DME Fee schedule for payment. Also, this procedure code is only payable for members under
the age of 21. Reimbursement for this equipment will not be manually priced using E1399.
ATTENTION Providers and Hospitals Eligible for the EHR Incentive Payment Program
On May 1, 2013, Louisiana Medicaid will launch the NEW AND IMPROVED LAConnect, the online portal for eligible providers to apply for Medicaid EHR incentive payments. On May 1st, providers will be able to access the new system and complete the attestation process for Year 1 and Year 2 incentive payments.
After March 31, 2013, the current method of attestation will no longer be used by Louisiana Medicaid for participation in the EHR Incentive Payment Program. All attestations received after March 31st will be returned to the provider, and the provider will be instructed to apply on May 1st, using the NEW AND IMPROVED LAConnect. We apologize for any inconvenience. However, this transition period is needed to ensure a smooth and problem-free launch of the NEW AND IMPROVED LAConnect.
REMINDER TO ALL DME AND PHARMACY PROVIDERS EMERGENCY PRIOR AUTHORIZATION REQUESTS
This is to advise that DHH has posted the procedures necessary to request prior authorization for medical equipment and supplies in emergency situations
as a reminder to all providers of durable medical equipment and supplies to the LA Medicaid website at http://www.lamedicaid.com/.
If you have any questions regarding the procedures please contact Molina Prior Authorization Department at 225-928-5263 or 1-800-488-6334.
ATTENTION DURABLE MEDICAL EQUIPMENT PROVIDERS
Effectively immediately DME providers are being advised to discontinue distributing the Abbott Enteral Therapy Pumps,
as DHH has been made aware that Abbott will be discontinuing their line of enteral pumps effective April 31, 2013.
This notice is to also advise that DHH will not be replacing any pumps unless the current pumps are no longer operable.
DHH has been advised that supplies for the discontinued pumps are available through Covidien, therefore it is not
necessary to replace any pumps that are fully operable.
Also, providers are cautioned not to attempt to retrieve the Abbott pumps from the recipient as the pumps were purchased
by DHH and are now the property of the recipients.
ATTENTION ALL PROVIDERS 2013 HCPCS UPDATE
The Louisiana Medicaid files are currently being updated to reflect the new and deleted HCPCS codes for 2013.
Once completed, a provider notice will be posted and claims that have been denied due to use of the new 2013
codes prior to their addition to our system will be systematically recycled.
Once this process is completed, providers will see claim denials of 2012 codes that are being deleted effective
December 31, 2012. Those claims should be resubmitted with the correct 2013 code.
ATTENTION IMMUNIZATION PROVIDERS
In July 2012, a 3.4% reduction was applied to Professional Services rates. Four Vaccine Administration
codes were erroneously included in this reduction, including 90471, 90472, 90473 and 90474. Affected
claims will be systematically corrected. The adjustments will appear on the March 26, 2013 Remittance
ATTENTION REHABILITATION CENTERS, OUTPATIENT
HOSPITAL REHABILITATION AND SCHOOL-BASED HEALTH CENTERS
Effective March 1, 2013, the definition for procedure code(s) 92507 and 92508 are being updated to reflect the
appropriate CPT code definition and remove the 15 minute increment as listed on the Louisiana Medicaid Fee Schedules.
The rates are being updated in accordance with the definition per occurrence/visit. Only one occurrence
may be billed per day. Providers should check with the appropriate health plans for billing instructions
on previous dates of service since implementation of Bayou Health, February 2012.
Please see the updated Rehabilitation Services Fee Schedule on http://www.lamedicaid.com/