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.

Billing Multiple Surgical Procedures

Providers are reminded that claims for multiple surgical procedures performed on the same date of service by the same rendering provider must be submitted at the same time. Overpayments due to fragmenting claim submissions are subject to review, recovery of the overpayment and additional sanctions as deemed appropriate by Louisiana Medicaid.

For questions related to this information, please contact Molina Medicaid Solutions Provider Services at (800)473-2783 or (225)924-5040.

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 who 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.

Attention Pharmacists and Prescribing Providers

Pharmacy claims for proton pump inhibitors for shared health plans or legacy recipients will still be subject to maximum duration of therapy of 120 days effective July 1, 2013. Claims which exceed the maximum duration of therapy will deny with EOB 697. To continue therapy past 120 days, MDs will need to get prior authorization. See http://www.lamedicaid.com/

ATTENTION ALL PROFESSIONAL SERVICE PROVIDERS:
Criteria for Wearable Cardioverter Defibrillator (WCD) Life Vest

Effective immediately, specific criteria must be met for Wearable Cardioverter Defibrillator Life Vest to be an approved service and reimbursed by Louisiana Medicaid. Please visit www.lamedicaid.com for the web notice, under the 2013 "Professional Services Program" link. It has also come to the Departments attention, that procedure code K0606 (WCD Life Vest) has been denied as a non-covered service for Louisiana Medicaid, due to being inadvertently omitted from the fee schedule. The fee schedule was updated April 2013 to include K0606 effective October 1, 2008. Prior Authorization is required for this service, to ensure medical necessity of WCD and will not be used for experimental or investigational purposes. If you have any questions please contact Molina Provider Relations (800)473-2783 or (225)924-5040.