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| Item Number | Policy/Procedure | Date Posted | Comment Period Closed | Status | Document Links |
|---|---|---|---|---|---|
| 2025-UHC-222 | Skin and Soft Tissue Substitutes | 6/30/25 | 8/14/25 | Pending | Skin and Soft Tissue Substitutes |
| 2025-LHCC-502 | Clinical Information and Documentation Policy | 6/30/25 | 8/14/25 | Pending | Clinical Information and Documentation Policy |
| 2025-UHC-558 | Surgery of the Knee | 6/30/25 | 8/14/25 | Pending | Surgery of the Knee |
| 2025-UHC-579 | Surgery of the Hip | 6/30/25 | 8/14/25 | Pending | Surgery of the Hip |
| 2025-LHCC-1213 | Sacroiliac Joint Fusion | 6/30/25 | 8/14/25 | Pending | Sacroiliac Joint Fusion |
| 2025-LHCC-1357 | Intestinal and Multivisceral Transplant | 6/30/25 | 8/14/25 | Pending | Intestinal and Multivisceral Transplant |
| 2025-LHCC-1379 | Inhaled Niric Oxide | 6/30/25 | 8/14/25 | Pending | Inhaled Niric Oxide |
| 2025-LHCC-1380 | Multiple Sleep Latency Testing | 6/30/25 | 8/14/25 | Pending | Multiple Sleep Latency Testing |
| 2025-LHCC-1382 | Lysis of Epidural Lesions | 6/30/25 | 8/14/25 | Pending | Lysis of Epidural Lesions |
| 2025-LHCC-1383 | Disc Decompression Procedures | 6/30/25 | 8/14/25 | Pending | Disc Decompression Procedures |
| 2025-LHCC-1413 | Discography | 6/30/25 | 8/14/25 | Pending | Discography |
| 2025-LHCC-1479 | High Complexity Medical Decision-Making | 6/30/25 | 8/14/25 | Pending | High Complexity Medical Decision-Making |
| 2025-LHCC-1917 | Repair of Nasal Valve Compromise | 6/30/25 | 8/14/25 | Pending | Repair of Nasal Valve Compromise |
| 2025-HUM-2721 | Low-Frequency, Noncontact, Nonthermal Ultrasound for Wound Care | 6/30/25 | 8/14/25 | Pending | Low-Frequency, Noncontact, Nonthermal Ultrasound for Wound Care |
| 2025-HUM-2723 | 23 Hour BH Observation | 6/30/25 | 8/14/25 | Pending | 23 Hour BH Observation |
| 2025-HUM-2724 | Freestanding Psychiatric Hospital for Adults ILOS | 6/30/25 | 8/14/25 | Pending | Freestanding Psychiatric Hospital for Adults ILOS |
| 2025-HUM-1556 | Care Management Program Description | 6/9/26 | 7/24/25 | Pending | Medicaid CM PD |
| 2025-HUM-1590 | Chiropractic - In Lieu Of Services | 6/9/26 | 7/24/25 | Pending | Chiropractic ILOS |
| 2025-LHCC-1700 | Care Management Program | 6/9/26 | 7/24/25 | Pending | Care Management Program |
| 2025-LHCC-1710 | Maternal Child Health Program Description | 6/9/26 | 7/24/25 | Pending | Maternal_Child_Health_Program_Description |
| 2025-LHCC-1845 | Pediatric Day Health Care Policy | 6/9/26 | 7/24/25 | Pending | Pediatric Day Health Care |
| 2025-LHCC-1904 | Homebuilders Services | 6/9/26 | 7/24/25 | Pending | Homebuilders Services |
| 2025-ABH-2363 | Hospice Services | 6/9/26 | 7/24/25 | Pending | Hospice Services |
| 2025-HUM-2367 | RSV Admin Codes CPT | 6/9/26 | 7/24/25 | Pending | CPT |
| 2025-LHCC-2664 | MediTrans Public Transportation Policy | 6/9/26 | 7/24/25 | Pending | Public Transportation Policy |
| 2025-HUM-2690 | Outpatient Facility | 6/9/26 | 7/24/25 | Pending | Outpatient Facility |
| 2025-HUM-2700 | HCPCS Drugs and Biologicals | 6/9/26 | 7/24/25 | Pending | HCPCS Drugs and Biologicals |
| 2025-HUM-2714 | CPT | 6/9/26 | 7/24/25 | Pending | CPT |
| 2025-ABH-2719 | Prior Authorization Requirement Change Notification | 6/9/26 | 7/24/25 | Pending | PA Requirement Change Notification |
| 2025-HUM-2722 | Skin and Tissue Substitutes | 6/9/26 | 7/24/25 | Pending | Skin and Tissue Substitutes |
| 2025-QS-1 | Louisiana’s Medicaid Managed Care Quality Strategy | 5/29/25 | 7/13/25 | Pending | Louisiana’s Medicaid Managed Care Quality Strategy |
| 2025-UHC-1395 | Motorized Spinal Traction | 5/27/25 | 7/11/25 | Pending | Motorized Spinal Traction |
| 2025-HUM-2708 | Drugs & Biologicals HCPCS | 5/21/25 | 7/5/25 | Pending | Drugs & Biologicals HCPCS |
| 2025-HUM-2709 | Drugs & Biologicals HCPCS | 5/21/25 | 7/5/25 | Pending | Drugs & Biologicals HCPCS |
| 2025-HUM-2710 | Drugs & Biologicals HCPCS | 5/21/25 | 7/5/25 | Pending | Drugs & Biologicals HCPCS |
| 2025-HUM-2711 | Drugs & Biologicals HCPCS | 5/21/25 | 7/5/25 | Pending | Drugs & Biologicals HCPCS |
| 2025-HUM-2712 | Drugs & Biologicals HCPCS | 5/21/25 | 7/5/25 | Pending | Drugs & Biologicals HCPCS |
| 2025-HUM-2713 | Drugs & Biologicals HCPCS | 5/21/25 | 7/5/25 | Pending | Drugs & Biologicals HCPCS |
| 2025-HUM-2716 | Revenue Codes | 5/21/25 | 7/5/25 | Pending | Revenue Codes |
| 2025-LHCC-2717 | Use of Out-of-Network Providers and Steerage | 5/21/25 | 7/5/25 | Pending | Use of Out-of-Network Providers and Steerage |
| 2025-ABH-1174 | Applied Behavior Analysis | 5/21/25 | 7/5/25 | Pending | Applied Behavior Analysis |
| 2025-LHCC-1388 | Code Edting Overview | 5/21/25 | 7/5/25 | Pending | Code Edting Overview |
| 2025-LHCC-1498 | Professional Component Modifier | 5/21/25 | 7/5/25 | Pending | Professional Component Modifier |
| 2025-LHCC-1505 | Moderate Conscious Sedation | 5/21/25 | 7/5/25 | Pending | Moderate Conscious Sedation |
| 2025-LHCC-1843 | Extended Home Health Services | 5/21/25 | 7/5/25 | Pending | Extended Home Health Services |
| 2025-HUM-1858 | 3-D Base Rendering | 5/21/25 | 7/5/25 | Pending | 3-D Base Rendering |
| 2025-LHCC-2184 | Organizational Assessment and Reassessment | 5/21/25 | 7/5/25 | Pending | Organizational Assessment and Reassessment |
| 2025-HUM-2368 | Tobacco Cessation CPT 7243 | 5/21/25 | 7/5/25 | Pending | Tobacco Cessation CPT 7243 |
| 2025-HUM-2677 | Outpatient Facility | 5/21/25 | 7/5/25 | Pending | Outpatient Facility |
| 2025-HUM-2678 | Correct Coding | 5/21/25 | 7/5/25 | Pending | Correct Coding |
| 2025-HUM-2680 | Correct Coding | 5/21/25 | 7/5/25 | Pending | Correct Coding |
| 2025-HUM-2681 | Correct Coding | 5/21/25 | 7/5/25 | Pending | Correct Coding |
| 2025-HUM-2682 | Modifiers | 5/21/25 | 7/5/25 | Pending | Modifiers |
| 2025-HUM-2683 | Modifiers | 5/21/25 | 7/5/25 | Pending | Modifiers |
| 2025-HUM-2684 | Diagnoses | 5/21/25 | 7/5/25 | Pending | Diagnoses |
| 2025-HUM-2685 | Ambulatory Surgical Center (ASC) | 5/21/25 | 7/5/25 | Pending | Ambulatory Surgical Center (ASC) |
| 2025-HUM-2687 | Evaluation and Management Services Louisiana Medicaid: injection, testosterone undecanoate | 5/21/25 | 7/5/25 | Pending | Evaluation and Management Services Louisiana Medicaid: injection, testosterone undecanoate |
| 2025-HUM-2699 | Drugs & Biologicals HCPCS | 5/21/25 | 7/5/25 | Pending | Drugs & Biologicals HCPCS |
| 2025-HUM-2706 | Drugs & Biologicals HCPCS | 5/21/25 | 7/5/25 | Pending | Drugs & Biologicals HCPCS |
| 2025-HUM-2707 | Drugs & Biologicals HCPCS | 5/21/25 | 7/5/25 | Pending | Drugs & Biologicals HCPCS |
Medicaid Managed Care Policies & Procedures
In accordance with La. R.S. 46:460.51, et seq., prior to adopting, approving, amending, or implementing certain policies or procedures, LDH will publish the proposed policy or procedure for the purpose of soliciting public comments. For this purpose, a policy or procedure, as defined by the statute, shall mean a requirement governing the administration of managed care organizations specific to billing guidelines, medical management and utilization review guidelines, case management guidelines, claims processing guidelines and edits, grievance and appeals procedures and process, other guidelines or manuals containing pertinent information related to operations and pre-processing claims, and core benefits and services.
The following table contains the LDH and managed care organization policies and procedures that are open for public comment.
RELATED INFO
- Previously posted for public comment
- Managed Care Policies & Procedures - Archive (2024)
- Managed Care Policies & Procedures - Archive (2023)
- Managed Care Policies & Procedures - Archive (2022)
- Managed Care Policies & Procedures - Archive (2021)
- Managed Care Policies & Procedures - Archive (2020)
- Managed Care Policies & Procedures - Archive (2019)
- MCO Managed Care Policies and Procedures Public Comments
- LDH Managed Care Policies and Procedures Public Comments