Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part XXIX - Pharmacy
Chapter 3 - Lock-In Program
Section XXIX-307 - Notification Directives
Universal Citation: LA Admin Code XXIX-307
Current through Register Vol. 50, No. 9, September 20, 2024
A. The department's contract designee shall notify the recipient of the decision to lock-in providers and shall include the following additional information:
1. the department's intention to allow the
recipient to choose one primary care provider, one pharmacy provider, and up to
three specialist providers, if warranted;
2. that Medicaid will make payments only to
the physician and pharmacy providers chosen by the recipient and subsequently
approved by the department;
3. that
the recipient is advised to contact the department's contract designee to
discuss the Pharmacy Lock-In Program; and
4. that the recipient has the right to appeal
the initial lock-in decision.
B. The department's contract designee shall be responsible for the following:
1. initiate
contact with the recipient in instances when the recipient fails to contact the
department, or its contractor;
2.
conduct a telephone interview when warranted with the recipient regarding the
Lock-In Program and the recipients rights and responsibilities;
3. assist the recipient, if necessary, in
exercising due process rights and complete the appropriate forms at the initial
contact; and
4 notify Lock-In
providers of their selection.
AUTHORITY NOTE: Promulgated in accordance with R.S. 46:153 and Title XIX of the Social Security Act.
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