LDA Legislative Update 5-29-08
HB1 – Appropriations – The bill has passed the House and is
currently being debated in the Senate Finance Committee. The House added $15 million in new funding
for dental EPSDT (Medicaid) reimbursement rate increases, and we anticipate
that a little more will be added in the Senate. However, no new funding was yet been added for the adult denture
program or to restore funding for the Donated Dental Services program. We have arranged to have member dentists
testify to the Finance Committee next week on both issues.
HB533 – Requires the
distribution of free medication samples to patient prior to prescribing – Died
in committee.
HB887 – lowers cap on
medical malpractice damages from $500K to $250K if patient (or insurer) has not
paid for medical services rendered – A little surprising that this bill
actually passed the House without being gutted. It is now pending before the Senate Health and Welfare Committee.
HB1372 – Abolishes
certain boards and commissions – The LDA got the author to agree to amend the
bill to preserve the Water Fluoridation Advisory Board when it gets to the
House floor. The bill is now awaiting a
vote by the full House.
SB96 – LSBD bill –
Provides for a few fees, including an application fee for the expungement of a
first-time advertising violation. Passed the House Health and Welfare Committee yesterday with no
opposition.
SB464 – would
prohibit balance billing by “facility-based” health care providers (i.e.,
providers in hospitals, surgical centers, etc.) even if they are not contracted
with a patient’s insurer – This bill was pushed strongly by the Insurance
Commissioner as a consumer protection issue. However, strong opposition by virtually the entire health care provider
community convinced the Senate Insurance Committee otherwise. The bill died in committee three weeks ago,
and though rumors have abounded that it will be resurrected by amending its
provisions onto another bill, this has not happened to date.
The House Health and
Welfare Committee, without objection, forwarded SB312, the LDA's fluoridation
bill, to the full House of Representatives yesterday with a favorable
recommendation. Before being passed by the committee, the bill was amended
twice. The first set of amendments were essentially technical changes to the
bill that the LDA made at the request of the DHH so the language in the bill
would more closely reflect that actual manner in which DHH would set about
implementing the bill's provisions. The second amendment was offered by Rep.
Kay Katz (R-Monroe), the committee chair, and it lowered from 30 to 15 the
percentage of registered voters in a community who must sign a petition in order
to force a local election to opt out of the fluoridation mandate. While not
exactly welcome, this amendment did not particularly concern us, and there is a
strong likelihood that the percentage can be increased when the bill goes to
conference committee.
The bill may be
amended once more when it gets to the House floor to address concerns expressed
by Rep. Burford (R-Stonewall) regarding the ability of voters in
unincorporated rural areas to be included in any opt out elections if they are
connected to water systems that primarily serve an incorporated municipality.
The bill currently only provides for elections to include residents within a
municipality who are served by a water system that would be subject to the
fluoridation mandate.
Though the LDA
representatives who testified on the bill did have to field a fair number of
questions from the committee members, there was no opposition expressed at all,
just as was the case as the bill made its way through the Senate. Assuming this
trend continues and the bill passes the full House (probably within the next
week to ten days), it should go to conference committee to iron out any (minor)
objections to the House amendments. There is little reason at this point to
expect significant opposition in either chamber to the conference committee
report, but we intend to maintain a strong grassroots lobbying effort until the
bill is finally passed.
As an aside, the
committee hearing was covered by the Baton Rouge Advocate. To view the story,
go to: http://www.2theadvocate.com/news/politics/19343394.html.
Please note that I was misquoted (as usual), but not as bad as I have been on
other occasions. The article itself isn't all that good or bad, but the
comments posted are rather interesting.
Attention All Louisiana Dental Medicaid
Providers
Implementation
Deadline for the National Provider Identifier
When the
National Provider Identifier (NPI) is implemented, Medicaid claims will not be
processed if the NPI(s) is not registered with Louisiana Medicaid,and you will
not receive your Medicaid payment. The NPI implementation deadline is May 23,
2008 and it is quickly approaching.
Effective
Immediately: All healthcare providers who do business with LA
Medicaid must provide their NPI in all transactions with Provider Enrollment,
such as enrolling in LA Medicaid, direct deposit change, and address change.
To maintain
accurate and timely payment of medical claims, the National Provider Identifier
(NPI) number must be used on all claims beginning May 23, 2008. Providers
should ensure that the NPI is indicated appropriately on claim submissions to
avoid payment denials.
It is
necessary to register your NPI with Louisiana Medicaid as this information is
not transmitted automatically from the enumerator. If you have not registered
your NPI(s), you may register online at www.lamedicaid.com
in the secured provider area, or by calling 225-216-6400 for assistance. For
additional instructions regarding applying for and registering your NPI, please
review the November/December Provider Update for this information. This
implementation may require system changes to your billing software. Therefore,
you should immediately contact your billing vendor or billing agent to ensure
your system reflects the necessary changes to add the NPI. These changes should
be tested to prevent a delay in your Medicaid payment.
Applying
for an NPI
To obtain an
NPI, health care providers must submit an application in one of two ways.
1) They may
apply through an easy web-based application process, at https://nppes.cms.hhs.gov,
or
2) They may
choose to prepare a paper application and send it to the enumerator (Fox
Systems). The paper application can be downloaded from the NPPES (National Plan
and Provider Enumeration System) web site, or providers may contact the
enumerator via the NPPES help line at 1-800-465-3203 (NPI Toll-Free)
1-800-692-2326 (NPI TTY) and request the paper application be sent to them.
Recommendations for Enumeration
LA Medicaid
will follow Medicare's enumeration recommendation which says that providers
should request a NPI for each of their legacy Medicaid ID numbers. The primary
reason for this recommendation is that it will assist LA Medicaid in building
the best possible cross-walk file from the NPI to the current Medicaid ID
number which will continue to be used for internal processing.
Louisiana Medicaid NPI Registration Application
One-to-One Registration:
LA Medicaid
providers should use the web based application located on the LA Medicaid web
site, www.lamedicaid.com, to register
their NPI(s) with LA Medicaid. The application is accessible from the secured
provider area of this web site. You may enter this location of the web site by
clicking the Provider Login button located at the upper left side of the Home
page. If you have not used this area of the web site before, you will be
prompted to complete a short online registration process. Once signed in to the
secured area, providers will see an application link called NPI.
Alternatively,
providers may choose to register their NPI using the NPI paper
registration form instead of the secured web application. The hard copy
registration form is available for download from the list of helpful web
links. The completed paper form may be faxed or mailed to Unisys as
indicated on the form.
Unisys (Fiscal
Agent for the Louisiana Department of Health and Hospitals) will contact the
registrant using the information provided on the registration form if there is
any problem during registration.
Other Registration:
If you plan to
enumerate with the NPPES in any other way than a one-to-one match (many-to-one
or one-to-many) you may use the NPI paper registration form, or contact the LA
Medicaid NPI Assistance Line at
This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
This e-mail address is being protected
from spam bots, you need JavaScript enabled to view it or (225) 216-6400 to discuss your NPI enumeration situation and
determine the best method for accommodating your circumstance.
Other Important Information:
Attention
Group Practices: Group practices must register the NPI associated with the
group Medicaid ID number as well as the NPIs assigned to the individual
practitioners within the group. LA Medicaid must be able to properly
identify both the billing and servicing provider on claims. This means that
both groups and individuals must be users of the secured area of the provider
website to register their NPIs. If you are not a current user, you will
need register on-line as indicated above. As an alternative to
registering via the secured web application, group providers may contact the
Louisiana NPI Assistance Line above for details on how to register the group
and their individuals using a bulk registration process.
Attention
Individual Practitioners: Individually practicing dentists who obtained an
individual NPI and a business entity NPI for Medicare billing must register
both NPIs with LA Medicaid to accommodate crossover claims processing.
Transitioning
to the NPI
For a
successful NPI implementation, all LA Medicaid providers must report their
NPI(s) to Unisys. The final compliance date is May 22, 2008.
Providers who
have not done so should immediately obtain an NPI, register it with LA Medicaid
and contact any billing or software vendor to allow time for systems to be
altered to accommodate the entry of the NPI (s).
If you have
not requested your NPI(s) from the National Plan and Provider Enumeration
System (NPPES) you must complete that process first then return to the LA
Medicaid NPI Registration application to register your NPI(s) after you have
received it.
Questions
regarding the LA Medicaid NPI implementation may be directed to the LA Medicaid
NPI Assistance Line at
This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
This e-mail address is being protected
from spam bots, you need JavaScript enabled to view it or (225) 216-6400.
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