RULEMAKING: Medicaid - Notices of Intent

August 10, 2018
Amends the provisions governing The Optimal PDL $olution (TOP$) State Supplemental Rebate Agreement Program in order to include pharmacy utilization of managed care organizations (MCOs) that participate in the Healthy Louisiana Program and implement a single state managed preferred drug list to maximize supplemental rebates on MCO utilization.
August 10, 2018
Amends the provisions governing the administrative procedures for the administration of the Medical Assistance Program in order to adopt provisions which require current or prospective employees, contractors or subcontractors, within the Medicaid eligibility section that have access to federal tax information or criminal history record information, to submit to criminal history records checks.
August 10, 2018
Repeals and replaces the Rules governing inpatient hospital services in order to adopt an all patient refined diagnostic related group reimbursement methodology and to revise the remaining provisions for inpatient hospital services to ensure that these provisions are appropriately promulgated in a codified format for inclusion in the Louisiana Administrative Code.
August 10, 2018
Amends the provisions governing provider participation in the Home Health Program in order to remove the accreditation requirements for pharmacies that provide medical equipment, supplies and appliances, in compliance with federal regulations mandated by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.
August 10, 2018
Amends the Rule governing the dental benefits prepaid ambulatory health plan in order to adopt provisions for the independent process for the review of dental benefit plan manager provider claims payment determinations that are adverse to dental providers.
July 10, 2018
Amends the provision governing rural health clinics reimbursements in order to implement a payment methodology for long-acting reversible contraceptive devices outside of the prospective payment system rates.
July 10, 2018
Amends the provisions governing outpatient hospital services in order to repeal the provisions governing duration of outpatient status to remove these procedural requirements from the Louisiana Administrative Code.
July 10, 2018
Amends the provisions governing managed care for physical and behavioral health in order to allow MCOs to utilize skilled nursing facilities for members who transition from acute care hospital services as a step-down continuum of care and to align the governing authorities with current operations and practices.
July 10, 2018
Amends the provisions governing the Community Choices Waiver (CCW) in order to: 1) align the provisions governing target population, service definitions and provider qualifications with the waiver approved by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services; 2) eliminate the non-medical transportation service; 3) amend the criteria for CCW priority offers to specify priority for individuals admitted to, or residing in, nursing facilities for whom Medicaid is the sole payer source; 4) change references to the minimum data set-home care to the International Resident Assessment Instrument (interRAI) assessment tool; and 5) allow OAAS to grant exceptions to waiver discharges for interruptions due qualifying circumstances.
July 10, 2018
Continues the provisions of the July 1, 2018 Emergency Rule which amended the provisions governing healthcare services provider fees in order to calculate, levy and collect an assessment for each assessed hospital, with the exception of facilities prohibited from participating in the Medicare Program and to increase provider fees for emergency ground ambulance service providers.