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
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 NURSING HOME ADMINISTRATIORS
As part of the budget reduction measures by the Department of
Health and Hospitals, Medicaid will no longer pay co-insurance on therapy
services (physical therapy, occupational therapy and speech/language therapy) on
Medicare/Medicaid Cross-over claims effective with Date of Service July 1, 2012.
Claims billed on or after this date of service will '0' pay with edit 384 -NOT
COVERED FOR NURSING HOME RESIDENT. If you have questions please contact Denis
Beard at 225-342-6116.
ATTENTION BAYOU HEALTH PROVIDERS
Due to a processing error during the month of March 2012,649
GSA A BAYOU HEALTH members who originally linked to Health Plans for February
reverted to legacy Medicaid for the month of March only. A review has been
conducted and all 649 members were relinked to their previous Health Plans
effective April 1st. Please verify member linkage on eMEVS if you are
getting denials for March 2012 dates of service. Providers should contact the
Molina Provider Relations Unit at (800) 473-2783 or (225) 924-5040 with billing
or policy questions regarding services provided to these members during the
month of March.
EHR INCENTIVE PAYMENT PROGRAM - UPDATE
Since January 2011, nearly 1,300 eligible medical professionals and
hospitals have received more than $120 million in incentive payments
through participation in Louisiana's Medicaid Electronic Health Records
(EHR) Incentive Payment Program. The EHR Incentive Payment Program is a
100% federally funded initiative that promotes the adoption and
meaningful use of certified EHR technology through the provision of
incentive payments to eligible professionals and hospitals. Eligible
professionals can receive a maximum of $63,750 in incentive payments
over a six-year period, and in 2011, the average payment to Louisiana's
participating hospitals was $1.1 million.