For Providers
Medicaid's Fiscal Intermediary (Molina) maintains the Louisiana Medicaid Provider Relations website, where providers can access information ranging from how to enroll as a Medicaid provider to directions for filling out a claim form. In addition, providers can have direct contact with the field analyst assigned to their areas or find information on provider training.
The State's Medicaid provider newsletter, The Provider Update, published by the fiscal intermediary several times a year, includes educational articles for providers on various diseases and treatments .
Health Standards
Within the Department of Health and Hospitals, the Health Standards section licenses health care facilities to operate in the state of Louisiana and certifies these facilities for participation in Medicare and Medicaid. Health Standards enforces regulatory compliance for health care facilities in the State of Louisiana.
Other Medicaid Offices with Provider Functions
Medicaid Management Information Systems (MMIS) - Administers the contract and monitors the budget of the Fiscal Intermediary (Molina), which is responsible for the payment of claims to providers and the timely and accurate reporting to state and federal personnel and private sector partners.
Medicaid Leadership & Medical Care Advisory Committee - Contributes specialized knowledge and experience and provides a two-way channel of communication with the individuals, organizations and institutions in the community that receive, provide and pay for medical care and services.
Pharmaceutical and Therapeutics Committee - Develops and maintains a prior authorization process with a preferred drug list, makes recommendations for additions and deletions to the preferred drug list and advises the DHH secretary on policy recommendations related to the prudent administration of the Medicaid drug program.
Rate & Audit Review Section - This section develops and administers complex reimbursement systems for several statewide Medicaid programs. It contracts with CPA consultant firms for the development of rate methodologies and for the audit of Medicaid providers participating in the programs stated above. It monitors these contracts, reviews and approves the consultants' audits, desk reviews and audit programs, and authorizes payments.
Provider Online Processing System (POPS) - This is a web-based application Health Standards Section is developing that will allow providers to perform more licensing transactions online.
Making Medicaid Better - This site provides an overview of the state's planned implementation of Coordinated Care Networks (CCN) to provide services for most Louisiana Medicaid and LaCHIP recipients. This health care delivery system change is expected to take place in 2012.
EHR Incentive Payment Program: Through this program, eligible medical professionals and hospitals receive incentive payments for adopting, implementing or upgrading certified EHR technology during their first year of participation, and can earn payments for up to five subsequent years for demonstrating meaningful use of electronic health records.
Helpful Resources for Medicaid Providers:
