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
Should you have any questions
regarding any of the following messages, please contact Molina Medicaid
Solutions at (800) 473-2783 or (225) 924-5040.
Attention Federally Qualified Health Centers (FQHC) and Rural Health Clinic (RHC) Providers
Effective April 1, 2019, and with dates of service forward, Louisiana Medicaid has established an alternative payment methodology (APM) for behavioral health services provided in
FQHC and RHC facilities. All FQHC and RHC providers should review the Informational Bulletin at http://www.ldh.la.gov/index.cfm/page/1198
for additional information regarding this change.
LDH is requesting that RHC and FQHC providers hold all behavioral health claim submissions, with dates of service beginning April 1, 2019, until further notification from LDH.
This will allow DXC Technology time to prepare their systems for processing these claims. Claims submitted prior to system updates may result in denial or incorrect payment
requiring submission of claim adjustments.
LDH will notify RHC and FQHC providers once the system can accept these claims.
Information regarding this change is forthcoming and will be located on www.lamedicaid.com under the Provider Manuals link, within the FQHC and RHC Provider manual.
An update the FQHC and RHC fee schedules is also forthcoming.
Questions regarding this notice and fee for service claims should be directed to DXC Technology Provider Relations at (800) 473‐2783 or (225) 924-5040.