RA Messages for April 21, 2009


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 A

    DRUG                                                             DOSE                                 STRG                                 FUL                 EFF.
ACETYLCYSTEINE                                         VIAL                                 200MG/ML                        0.26800             4/30/09
ALENDRONATE SODIUM                             TABLET                             5MG                                  0.42930             4/30/09
ALENDRONATE SODIUM                             TABLET                             10MG                                0.42930             4/30/09
BISOPROL/HYDROCHLOROTHIAZIDE       TABLET                             10-6.25MG                       0.25420             4/30/09
CLOBETASOL PROPIONATE                        GEL,TOP                            0.05%                                0.46400            4/30/09
CLOBETASOL PROPIONATE                        OINT,TOP                         0.05%                                0.19400             4/30/09
CLOBETASOL PROPIONATE                        SOL,TOP                           0.05%                                0.42000             4/30/09
FLUOROURACIL                                             SOL,TOP                           5%                                     11.68950           4/30/09
FOSINOPRIL/HYDROCHLOROTHIAZIDE    TABLET                             10-12.5MG                       1.34540             4/30/09
FOSINOPRIL/HYDROCHLOROTHIAZIDE    TABLET                             20-12.5MG                       1.34540             4/30/09
HYDRALAZINE HCL                                        TABLET                             10MG                               0.25560             4/30/09
HYDRALAZINE HCL                                        TABLET                             25MG                               0.32840             4/30/09
HYDRALAZINE HCL                                        TABLET                             50MG                               0.42000             4/30/09
HYDRALAZINE HCL                                        TABLET                             100MG                             0.78380             4/30/09
HYDROCHLOROTHIAZIDE                            CAPSULE                           12.5MG                           0.12000             4/30/09
HYDROCORTISONE BUTYRATE                  CR,TOP                               0.10%                              1.11770             4/30/09
MOEXIPRIL/HYDROCHLOROTHIAZIDE      TABLET                              7.5/12.5MG                     1.21110             4/30/09
MOEXIPRIL/HYDROCHLOROTHIAZIDE      TABLET                             15/12.5MG                       1.21110             4/30/09
MOEXIPRIL/HYDROCHLOROTHIAZIDE      TABLET                             15/25MG                          1.21110             4/30/09
NYSTATIN                                                        ORAL SUSP                      100K U/ML                      0.20620             4/30/09
ORPHENADRINE CITRATE                            TABLET SA                       100MG                             1.04250             4/30/09
OXCARBAZEPINE                                           TABLET                             150MG                             0.90000             4/30/09
OXCARBAZEPINE                                           TABLET                             300MG                             1.71000             4/30/09
OXCARBAZEPINE                                           TABLET                             600MG                             3.42000             4/30/09
PERPHENAZINE                                              TABLET                             2MG                                 OFF MAC         4/30/09
PERPHENAZINE                                              TABLET                             16MG                               OFF MAC         4/30/09
PILOCARPINE                                                 TABLET                             7.5MG                               1.94250             4/30/09
PRAZOSIN HCL                                              CAPSULE                           5MG                                 0.53700             4/30/09
PROPRANOLOL HCL                                    CAP.SA 24H                       60MG                                1.32240             4/30/09
PROPRANOLOL HCL                                    TABLET                              60MG                                0.67140             4/30/09
RISPERIDONE                                                TABLET                               0.25MG                            1.30050             4/30/09
RISPERIDONE                                                TABLET                               0.5MG                              1.42730             4/30/09
RISPERIDONE                                                TABLET                               1MG                                 1.51730             4/30/09
RISPERIDONE                                                TABLET                               2MG                                 2.53580             4/30/09
RISPERIDONE                                                TABLET                               3MG                                 2.97830             4/30/09
RISPERIDONE                                                TABLET                               4MG                                 4.00020             4/30/09
ROPINIROLE HCL                                         TABLET                               0.25MG                            0.75150             4/30/09
ROPINIROLE HCL                                         TABLET                               0.5MG                              0.75150             4/30/09
ROPINIROLE HCL                                         TABLET                               5MG                                 0.77960             4/30/09
TRIAMCINOLONE ACET                             CR, TOP                              0.025%                             0.03750             4/30/09
VENLAFAXINE HCL                                     TABLET                               25MG                              1.16580             4/30/09
VENLAFAXINE HCL                                     TABLET                               37.5MG                           1.20030             4/30/09
VENLAFAXINE HCL                                     TABLET                               50MG                              1.23660             4/30/09
VENLAFAXINE HCL                                     TABLET                               75MG                              1.31100             4/30/09
VENLAFAXINE HCL                                     TABLET                               100MG                            1.38920             4/30/09

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


For Medicaid pharmacy services effective May 1, 2009, the Department of Health and Hospitals, Bureau of Health Services Financing will establish a five-prescription limit per recipient per calendar month. Please refer to www.lamedicaid.com for detailed information.


Louisiana Medicaid's policy on obstetrical ultrasounds has been updated and clarified. Providers submitting claims for these services are responsible for, and expected to comply with, Medicaid policy. The clarification is currently published on the Medicaid website homepage, found at www.lamedicaid.com, and will also be published in an upcoming edition of the "Louisiana Medicaid Provider Update."


The Centers for Disease Control and Prevention (CDC) has issued a Health Advisory Alert regarding Haemophilus influenzae Type B disease and a documented shortage of the vaccine for this disease. Included in this alert are recommendations from the CDC for the provision of the vaccine during this time of vaccine shortage. A link to this important Health Advisory Alert can be found on the homepage of the Medicaid website, www.lamedicaid.com. Louisiana Medicaid urges all providers of pediatric vaccines to review this information. For further information on Haemophilus influenza Type B conjugate vaccination, please visit the LINKS Immunization Registry at https://linksweb.oph.dhh.louisiana.gov/linksweb/main.jsp


Effective March 30, 2009, HMS assumed the responsibility of updating the TPL Resource Files for recipients with private insurance. A new form for reporting TPL information updates was introduced in the Spring 2008 TPL provider training workshops. At that time, providers were given the option to either submit the form via fax or to continue to mail the form with the affected claims to the TPL Unit. With the transition to HMS, providers should discontinue submitting claims with the TPL Information Update form. Effective immediately, the update form must be FAXED to HMS at 1-866-976-2215. An EOB or carrier letter supporting the requested update should be included when/if available. Any claims submitted with these requests will not be processed; they will be considered documentation only. Processing of your requests should only take one week. Providers should hold any and all claims until the recipient file is updated, then submit the claims through normal processing channels. Providers should check this information through the recipient eligibility options, e-MEVS, MEVS, or REVS, to ensure that the update has occurred. The new TPL form, Medicaid Recipient Insurance Information Update, is located on the homepage of the La Medicaid website, www.lamedicaid.com, under the link, "TPL Information." Questions concerning updates should be addressed to HMS at 1-866-976-2210.