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 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.


ATTENTION: ALL PROVIDERS BILLING MEDICAID RECIPIENTS FOR SERVICES

This message is to remind all providers that within your agreement of participation with Louisiana Medicaid you agree to accept the Medicaid payment as payment in full for services rendered to Medicaid recipients, providing for the allowances for co-payments authorized by Medicaid.

A recipient may be billed for services that have been determined as non-covered or exceeding the services limit for recipients over the age of 21. Recipients are also responsible for all services rendered after his/her eligibility has ended. Providers shall not bill recipients in instances where provider billing errors have caused a denied claim. In order to bill a recipient for a non-covered service, the recipient must be informed both verbally and in writing that he/she will be responsible for payment of the services.

NOTE: A recipient delay in receiving authorized Medicaid covered services are prohibited by Louisiana Medicaid.


ATTENTION Professionals 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, eligible professionals and hospitals will be able to access the new system via lamedicaid.com and complete the attestation process for Adoption, Implementation, or Upgrade or Meaningful Use of certified electronic health technology. To attest, go to lamedicaid.com, enter your logon credentials, and click on the LAConnect link.


Primary Care Services Enhanced Reimbursement Update

The deadline to submit a Designated Physician form and receive an effective date for enhanced reimbursement retrospective to January 1, 2013 has been extended further. The deadline is now June 28, 2013. If Molina Provider Enrollment receives your complete and correct form by June 28, 2013, you will receive enhanced reimbursement for eligible services rendered on or after January 1, 2013. If your complete and correct form is received after June 28, 2013, you will receive enhanced reimbursement for eligible services rendered on or after the date the form is received.

If you submitted a Designated Physician form to PRJSM but have not received notice from Molina that it was received, you must submit an original Designated Physician form to Molina. The current Designated Physician form (revised on 4/8/13) can be found at http://www.lamedicaid.com/provweb1/Provider_Enrollment/existingenrollments.htm.

For additional information, please review "ATTENTION PRIMARY CARE PROVIDERS: Affordable Care Act Enhanced Reimbursement of Primary Care Services Informational Bulletin" posted on http://www.lamedicaid.com.


Eligible Medicaid Providers are encouraged to participate in a National Provider Call, hosted by CMS, on Thursday, May 30th for the Medicare and Medicaid Incentive Programs. See registration and other information below. National Provider Call: Stage 1 of the Medicare & Medicaid EHR Incentive Programs for Eligible Professionals: First in a Series � Registration Now Open Thursday May 30; 12:30-2 PM CT,

This session will inform individual practitioners on the basics of Stage 1 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. Learn if you are eligible, and if so, what you need to do to earn an incentive. This is the first in a series of 6 National Provider Calls on the Medicare and Medicaid EHR Incentive Programs.

Agenda:

  • Are you eligible?
  • How much are the incentives and how are they calculated?
  • How do you get started?
  • What are major milestones regarding participation and payment?
  • How do you report on meaningful use?
  • Where can you find helpful resources?
  • Question and Answer Session

Registration Information:

In order to receive call-in information, you must register for the call on the  CMS Upcoming National Provider Calls registration website. Registration will close at 12pm on the day of the call or when available space has been filled; no exceptions will be made, so please register early.

Future National Provider Calls:

DATE

TIME

TOPIC

June 27

2:30 - 3:45

Certification w/ONC

July 23

1:30 - 3

CQMs

July 24

1:30 - 3

Stage 2

Aug 13

1:30 - 3

Hardship Exceptions

Aug 15

1:30 - 3

Payment Adjustments