Medicaid Redeterminations Webinars (Also known as Unwind)
In March 2020, Louisiana Medicaid changed some of its eligibility rules in response to the federal COVID-19 public health emergency (PHE). This included stopping closures for most Louisiana Medicaid members.
Starting in April, Louisiana Medicaid must re-start eligibility reviews and close anyone who is not eligible. Eligibility reviews are also called renewals. Not everyone will renew at the same time. It will take 12 months to renew all Medicaid members.
You are invited to join Medicaid for a Provider Webinar to learn more about what this means for Medicaid members and providers. Visit www.ldh.la.gov/providerwebinars.
Contact Information Form
The most important thing Medicaid members can do is update their contact information. This can be done in several ways including through a provider’s office. Providers can have Medicaid members complete our Contact Information Update form.
When using the form:
- Complete with as much information as possible. The member’s name, date of birth and last four digits of their social are required.
- The form must be signed by hand. No digital or electronic signatures will be accepted.
- Forms can be submitted to Medicaid by email or by fax.
- Providers can give them to Medicaid members to complete and submit on their own OR providers can have the member complete the form in the office and then submit it to Medicaid on the member’s behalf. Forms may be submitted to Medicaid one at a time or in batches.
Provider Enrollment Portal
The Provider Enrollment Portal at www.lamedicaid.com remains open for providers required to complete enrollment. Approximately 25% of Louisiana providers have not completed this required enrollment. Claims will be denied for providers who do not enroll.
Important Notes:
- Providers with multiple provider types must complete enrollment for each type. Providers should expect impacts to claims processing, and risk not getting paid if enrollment is not complete.
- Any providers who have not completed enrollment by June 30, 2023, will have their patients assigned to another primary care physician and will be terminated from the program.
Claims Adjudication - Ordering, Prescribing or Referring Providers (OPR)
Claims processing guidelines depend on when a provider enrolls. If enrollment is not complete, claims and payments will be impacted. If an OPR provider is included on a claim or writes a prescription and has not completed enrollment:
- The medical/professional claim will deny beginning July 1, 2023, if any one of the following are not enrolled:
o Ordering provider
o Prescribing provider
o Referring provider
- The prescription will deny beginning July 1, 2023, if any one of the following are not enrolled:
o Prescribing provider
o Vaccinating pharmacist, or
o Pharmacy provider
Providers that are unsure of their enrollment status may use the Provider Portal Enrollment Lookup Tool at https://www.lamedicaid.com/portalenrollmentstatus/search. Results will show the provider’s status as either enrollment complete, action required, application not submitted, or currently in process by Gainwell Technologies. Providers that are not shown in the results are not required to enroll at this time. Invitation letters for those providers will be sent at a later date. The Lookup Tool is updated daily.
