State Plan Amendments

Louisiana’s Medicaid State Plan is an agreement between the state and the Federal government describing how Louisiana administers its Medicaid and children’s health insurance programs (CHIP). State Plan amendments (SPA) are requests from Louisiana to the Centers for Medicare & Medicaid Services (CMS) to make a change to the Louisiana Medicaid program’s policies or operational approach, make corrections, or updates to the state plan with new information. For information about current State Plan amendment submissions click here

Below are SPAs Louisiana will send to CMS for review and approval beginning August 1, 2019. To provide feedback, please complete this form.

Item Number State Plan Title Summary of Change Date Posted Public Comments Due By Document Links
SPA-2019-1 Medicaid Eligibility - Medicare Savings Programs

The purpose of this SPA is to amend the provisions governing financial eligibility in the Medical Assistance Program, in order to disregard all resources in eligibility determinations for all Medicare Savings Programs.

 8/23/19  9/22/19 Supplement 8b to Atachment 2.6-A, Page 2
SPA-2019-2

Managed Care Organizations Open Enrollment Choice Period

The purpose of this SPA is to amend the provisions governing the enrollment choice period for Medicaid beneficiaries enrolled in a Managed Care Organization, from a 90-day period to a minimum of 30 days.

9/12/19 9/19/19 Attachment 3.1-F, Pages 11-12
SPA-2019-3

Pharmacy Benefits Management Program - Drug Utilization Review Program

The purpose of this SPA is to implement Medicaid drug utilization review (DUR) provisions, in compliance with the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, that are designed to reduce opioid-related fraud, misuse and abuse, including:

 

  1. Opioid prescription claim reviews at the point of sale (POS) and retrospective reviews;
  2. Monitoring and management of antipsychotic medication in children; and
  3. Identification of processes to detect fraud and abuse.
9/13/19 9/20/19 Section 4.26, Pages 74-D and 74-E.