Full Medicaid Pricing (FMP) Program Initiative for Dentists
If you are a Medicaid provider who initially chose not to submit a Letter of Intent to participate in the Louisiana Full Medicaid Pricing (FMP) program for dental Medicaid providers (or if you were not a Medicaid provider at that time), the Louisiana Department of Health (LDH) is allowing us to contract new providers with a starting date of July 1, 2020.
However, the caveat is that a contract must be submitted immediately. If you submitted a contract already, you DO NOT NEED TO RESEND A CONTRACT. You will automatically stay in the program for the next fiscal year.
Please complete and sign the attached by Wednesday, May 27, 2020, to participate. Below are instructions for completion of the attached Dental Services Agreement between each dental provider and the Louisiana Medicaid Dental IPA, Inc. (“IPA”), and a brief summary of the program. The LDA is assisting the IPA with disseminating these agreements to you.
- Insert the provider’s name on page 1 – this should be the name of the person or entity that receives Medicaid payments.
- Please complete Exhibit 1.5 with your identifying information. If you have multiple providers who bill under a single Medicaid provider number, you should list the primary billing entity/individual, the number and the other providers who also bill under that number.
- Attach the provider’s W9 (for Exhibit 2.3.9).
- Sign, date and give the provider’s address on page 10.
Please contact Emily at 225-381-8011 to address any issues with transmitting the agreement.
The IPA is working with the Louisiana Department of Health (“LDH”) on the final stages of implementation of the Dental Full Medicaid Pricing (“Dental FMP”) Program. One requirement of participation in the Dental FMP program is affiliating with the LSU School of Dentistry (“LSUSD”). The LSUSD has authorized the IPA exclusively to affiliate dentists with the LSUSD, as set forth in Louisiana Medicaid State Plan Amendment No. 17-0011. The attached Agreement accomplishes the LSUSD affiliation and assists LSUSD in meeting its obligations under its agreement with the dental Medicaid managed care organization(s) including as MCNA, including its obligation to increasing access to oral health.
In addition to the affiliation with LSUSD, the Agreement also sets forth the initial criteria that will be used in calculating the quarterly FMP payments to dentists known as “Payment Enhancement Protocols” or “PEP.” It is important to note that the FMP Payments do not replace the payments or existing obligations between dentists and the dental managed care organization (currently MCNA). The FMP payments are different in character than payments for services to the managed care organization’s Medicaid enrollees.
The Agreement also outlines obligations of the providers, including reporting data when necessary and other provider representations.
If you are already a provider or just signed up, please click here to let the LDA know so that we can maintain updated records.
For the most recent updates and information from the Department of Health and Hospitals, visit the Louisiana Medicaid Web site at www.lamedicaid.com.
The five Healthy Louisiana plans are:
- Aetna Better Health
- Healthy Blue (formerly Amerigroup Real Solutions)
- Amerihealth Caritas Louisiana
- Louisiana Healthcare Connections
- UnitedHealthcare Community Plan
HOW TO CONTRACT WITH MCNA DENTAL (Louisiana's dental benefit program manager)
In 2014, MCNA Dental was selected by the Louisiana Department of Health and Hospitals to administer its Medicaid and CHIP dental programs statewide. MCNA would like to invite all Louisiana dentists to join the MCNA network of dentists. For your convenience, the documents that must be completed and submitted for credentialing are available on our website http://www.mcnala.net/
• Credentialing Application (Please submit one application per dentist)
• W-9 Form
• Direct Deposit EFT Form
HOW TO CONTRACT WITH HEALTHY LOUISIANA (Louisiana's medical Medicaid program managers, updated 10/23/19)
All five Healthy Louisiana plans offer a limited dental benefit in addition to the current Medicaid Dental Benefit managed by MCNA.
Amerigroup and Aetna contract with DentaQuest to manage the dental benefit. Information relative to credentialing and benefits offered can be found on the Dentist Page link at www.dentaquest.com/Louisiana or by contacting the credentialing hotline at 1-800-233-1468.
United Healthcare Community Plan of Louisiana (UHC) ask interested dental providers to contact the United Healthcare Dental Provider Services line at 1-844-275-8751.
Health Professional Shortage Area (HPSA)
HPSAs are defined service areas that demonstrate a critical shortage of primary care physicians, dentists, or mental health providers. An HPSA can be a distinct geographic area such as a parish or grouping of census tracts, a specific population group within a defined geographic area (such as a population under 200% poverty), or a specific public or non-profit facility such a state hospital. You can learn more about HPSAs by visiting the Louisiana Department of Health and Hospitals (DHH) website.