Medicaid

The audit noted the Department has established a process to conduct more frequent wage data checks which has improved its ability to ensure that only eligible individuals are enrolled in the program.

The purpose of this Request for Proposal (RFP) is to obtain competitive proposals from highly qualified and experienced External Quality Review Organizations (EQRO) to perform independent external quality review (EQR) services that consist of mandatory and optional activities as outlined in the Code of Federal Regulations (CFR) Title 42 CFR § 438 Subpart E.

In compliance with the provisions of 42 CFR § 438.340, the Louisiana Department of Health, Bureau of Health Services Financing is taking the opportunity to make the Louisiana Medicaid Quality Strategy available for public comment.

In compliance with the provisions of 42 CFR § 438.340, the Louisiana Department of Health, Bureau of Health Services Financing is taking the opportunity to make the Louisiana Medicaid Quality Strategy available for public comment.

This system electronically records and documents precisely the type of service performed, the individual receiving the service, the date of the service, the location of service delivery, the individual providing the service, and the time the service begins and ends.

Louisiana was recognized this week by the federal Centers for Medicare & Medicaid Services (CMS) for implementing best practices aimed at eliminating waste, fraud and abuse in state Medicaid programs. Louisiana is one of only eight states to receive this honor.

The new online Public Records Request Portal gives users the opportunity to submit public records requests, track their records requests and view an archive of all publicly-accessed records.

Last month, the Louisiana Department of Health unveiled a new Medicaid eligibility and enrollment system that uses the most up-to-date technology to ensure accurate eligibility determinations. This new system addresses many of the limitations of the former, outdated system as identified by the Department, the Legislature and the auditor.

Louisiana’s new Medicaid eligibility and enrollment system will now give the health department access to federal income tax data of potential Medicaid enrollees to ensure they are eligible for Medicaid. This capability is in addition to numerous other income and employment data sources that are now available to Medicaid to ensure that all recipients meet the strict financial eligibility standards.

In its most recent audit of the Louisiana Department of Health, the Legislative Auditor cited several instances in which reductions to the health agency’s budget limited the effectiveness of its Medicaid fraud detection efforts.