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| Item Number | Policy/Procedure | Date Posted | Comment Period Closed | Status | Document Links |
|---|---|---|---|---|---|
| 2025-LHCC-1507 | Clinical Validation of Modifier 59 | 9/19/25 | 11/3/25 | Pending | Clinical Validation of Modifier 59 |
| 2025-LHCC-1509 | Clinical Validation of Modifier 25 | 9/19/25 | 11/3/25 | Pending | Clinical Validation of Modifier 25 |
| 2025-HUM-1644 | Eyebrow and Eyelid Repair | 9/19/25 | 11/3/25 | Pending | Eyebrow and Eyelid Repair |
| 2025-HUM-1661 | Molecular Diagnostic Assays and Breath Testing for Transplant Rejection Clinical Coverage Policy | 9/19/25 | 11/3/25 | Pending | Molecular Diagnostic Assays and Breath Testing for Transplant Rejection Clinical Coverage Policy |
| 2025-UHC-206 | Electric Tumor Treatment Field Therapy | 9/11/2025 | 10/26/2025 | Pending | Electric Tumor Treatment Field Therapy |
| 2025-UHC-222 | Skin and Soft Tissue Substitutes | 9/11/2025 | 10/26/2025 | Pending | Skin and Soft Tissue Substitutes |
| 2025-UHC-311 | Transcatheter Heart Valve Procedures | 9/11/2025 | 10/26/2025 | Pending | Transcatheter Heart Valve Procedures |
| 2025-UHC-379 | Brow Ptosis and Eyelid Repair | 9/11/2025 | 10/26/2025 | Pending | Brow Ptosis and Eyelid Repair |
| 2025-UHC-524 | Durable Medical Equipment, Orthotics, Medical Supplies and Repairs/Replacements | 9/11/2025 | 10/26/2025 | Pending | Durable Medical Equipment, Orthotics, Medical Supplies and Repairs/Replacements |
| 2025-UHC-558 | Surgery of the Knee | 9/11/2025 | 10/26/2025 | Pending | Surgery of the Knee |
| 2025-UHC-559 | Implantable Beta-Emitting Microspheres | 9/11/2025 | 10/26/2025 | Pending | Implantable Beta-Emitting Mocrospheres |
| 2025-UHC-561 | Cognitive Rehabilitation | 9/11/2025 | 10/26/2025 | Pending | Cognitive Rehabilitation |
| 2025-UHC-579 | Surgery of the Hip | 9/11/2025 | 10/26/2025 | Pending | Surgery of the Hip |
| 2025-UHC-1399 | Glaucoma Surgical Treatment | 9/11/2025 | 10/26/2025 | Pending | Glaucoma Surgical Treatment |
| 2025-UHC-1418 | Autologous Cellular Therapy | 9/11/2025 | 10/26/2025 | Pending | Autologous Cellular Therapy |
| 2025-UHC-1426 | Genetic Testing for Cardiac Disease | 9/11/2025 | 10/26/2025 | Pending | Genetic Testing for Cardiac Disease |
| 2025-UHC-2188 | Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials | 9/11/2025 | 10/26/2025 | Pending | Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials |
| 2025-UHC-2252 | Hospital Services: Observation and Inpatient | 9/11/2025 | 10/26/2025 | Pending | Clinical Policy Guidelines |
| 2025-ACLA-2745 | Clinical Policy Guidelines | 9/11/2025 | 10/26/2025 | Pending | Hospital Services: Observation and Inpatient |
| 2025-LHCC-690 | Outpatient Habilitative and Rehabilitative Speech Therapy | 9/3/25 | 10/18/25 | Pending | Outpatient Habilitative and Rehabilitative Speech Therapy |
| 2025-LHCC-1109 | Diaphragmatic/Phrenic Nerve Stimulation | 9/2/25 | 10/17/25 | Pending | Diaphragmatic/Phrenic Nerve Stimulation |
| 2025-LHCC-1228 | Sacroiliac Joint Interventions for Pain Management | 9/2/25 | 10/17/25 | Pending | Sacroiliac Joint Interventions for Pain Management |
| 2025-LHCC-1265 | Vagus Nerve Stimulation | 9/2/25 | 10/17/25 | Pending | Vagus Nerve Stimulation |
| 2025-LHCC-1271 | Implantable Hypoglossal Nerve Stimulation for OSA | 9/2/25 | 10/17/25 | Pending | Implantable Hypoglossal Nerve Stimulation for OSA |
| 2025-LHCC-1274 | Osteogenic Stimulation | 9/2/25 | 10/17/25 | Pending | Osteogenic Stimulation |
| 2025-LHCC-1284 | Preventive Health and Clinical Practice | 9/2/25 | 10/17/25 | Pending | Preventive Health and Clinical Practice |
| 2025-HBL-1311 | Bone Anchored and Bone Conduction Hearing Aids | 9/2/25 | 10/17/25 | Pending | Bone Anchored and Bone Conduction Hearing Aids |
| 2025-LHCC-1412 | Clinical Policy: Clinical Trials | 9/2/25 | 10/17/25 | Pending | Clinical Policy: Clinical Trials |
| 2025-LHCC-1524 | Posterior Tibial Nerve Stimulation for Voiding Dysfunction | 9/2/25 | 10/17/25 | Pending | Posterior Tibial Nerve Stimulation for Voiding Dysfunction |
| 2025-LHCC-1525 | Intradiscal Steroid Injections for Pain Management | 9/2/25 | 10/17/25 | Pending | Intradiscal Steroid Injections for Pain Management |
| 2025-LHCC-1526 | Trigger Point Injections | 9/2/25 | 10/17/25 | Pending | Trigger Point Injections |
| 2025-LHCC-1744 | Phototherapy for Neonatal Hyperbilirubinemia | 9/2/25 | 10/17/25 | Pending | Phototherapy for Neonatal Hyperbilirubinemia |
| 2025-LHCC-2225 | Lantidra (donislecel) Allogeneic Pancreatic Islet Cellular Therapy | 9/2/25 | 10/17/25 | Pending | Lantidra (donislecel) Allogeneic Pancreatic Islet Cellular Therapy |
| 2025-HUM-1548 | Individual Placement and Support (IPS) | 8/5/25 | 9/19/25 | Pending | Individual Placement and Support (IPS) |
| 2025-HUM-1657 | Hospital Bed Clinical Coverage Policy | 8/5/25 | 9/19/25 | Pending | Hospital Bed Clinical Coverage Policy |
| 2025-LHCC-1746 | Total Artificial Heart | 8/5/25 | 9/19/25 | Pending | Total Artificial Heart |
| 2025-LHCC-1840 | Cochlear Implants and Replacements | 8/5/25 | 9/19/25 | Pending | Cochlear Implants and Replacements |
| 2025-LHCC-1945 | Homocysteine Testing | 8/5/25 | 9/19/25 | Pending | Homocysteine Testing |
| 2025-LHCC-2178 | Allogeneic Hematopoietic Progenitor Cell Therapy | 8/5/25 | 9/19/25 | Pending | Allogeneic Hematopoietic Progenitor Cell Therapy |
| 2025-LHCC-2352 | ID Multisystem Lab Testing | 8/5/25 | 9/19/25 | Pending | ID Multisystem Lab Testing |
| 2025-LHCC-2353 | Dermatologic Lab Testing | 8/5/25 | 9/19/25 | Pending | Dermatologic Lab Testing |
| 2025-LHCC-2355 | ID Vector Borne and Tropical Disease Lab Testing | 8/5/25 | 9/19/25 | Pending | ID Vector Borne and Tropical Disease Lab Testing |
| 2025-LHCC-2356 | Primary Care Preventative Lab Testing | 8/5/25 | 9/19/25 | Pending | Primary Care Preventative Lab Testing |
| 2025-LHCC-2357 | ID Genitourinary Lab Testing | 8/5/25 | 9/19/25 | Pending | ID Genitourinary Lab Testing |
| 2025-LHCC-2359 | Gastroenterologic Lab Testing | 8/5/25 | 9/19/25 | Pending | Gastroenterologic Lab Testing |
| 2025-HUM-2528 | Applied Behavioral Analysis DRAFT | 8/5/25 | 9/19/25 | Pending | Applied Behavioral Analysis DRAFT |
| 2025-LHCC-111 | Functional Family Therapy - Child Welfare | 8/5/25 | 9/19/25 | Pending | Functional Family Therapy - Child Welfare |
| 2025-UHC-378 | Surgery of the Shoulder | 8/5/25 | 9/19/25 | Pending | Surgery of the Shoulder |
| 2025-UHC-476 | Cytological Examination of Breast Fluids for Cancer Screening or Diagnosis | 8/5/25 | 9/19/25 | Pending | Cytological Examination of Breast Fluids for Cancer Screening or Diagnosis |
| 2025-UHC-478 | Obstructive and Central Sleep Apnea Treatment | 8/5/25 | 9/19/25 | Pending | Obstructive and Central Sleep Apnea Treatment |
| 2025-LHCC-499 | Retrospective Review For Services Requiring Authorizations | 8/5/25 | 9/19/25 | Pending | Retrospective Review For Services Requiring Authorizations |
| 2025-UHC-562 | Sinus Surgeries and Interventions | 8/5/25 | 9/19/25 | Pending | Sinus Surgeries and Interventions |
| 2025-LHCC-603 | Coordinated System of Care (CSoC) PP | 8/5/25 | 9/19/25 | Pending | Coordinated System of Care (CSoC) PP |
| 2025-UHC-794 | Noncontact Warming Therapy, Ultrasound therapy and Flurescence Imaging for Wounds | 8/5/25 | 9/19/25 | Pending | Noncontact Warming Therapy, Ultrasound therapy and Flurescence Imaging for Wounds |
| 2025-LHCC-1108 | Pediatric Liver Transplant | 8/5/25 | 9/19/25 | Pending | Pediatric Liver Transplant |
| 2025-LHCC-1211 | Reduction Mammoplasty and Gynecomastia Surgery | 8/5/25 | 9/19/25 | Pending | Reduction Mammoplasty and Gynecomastia Surgery |
| 2025-LHCC-1227 | Skin and Soft Tissue Substitutes for Chronic Wounds | 8/5/25 | 9/19/25 | Pending | Skin and Soft Tissue Substitutes for Chronic Wounds |
| 2025-UHC-1393 | Panniculectomy and Body Contouring Procedures | 8/5/25 | 9/19/25 | Pending | Panniculectomy and Body Contouring Procedures |
| 2025-UHC-1400 | Occipital Nerve Injections and Ablations | 8/5/25 | 9/19/25 | Pending | Occipital Nerve Injections and Ablations |
| 2025-LHCC-1452 | Caudal or Interlaminar Epidural Steroid Injections | 8/5/25 | 9/19/25 | Pending | Caudal or Interlaminar Epidural Steroid Injections |
| 2025-LHCC-1454 | Facet Joint Interventions | 8/5/25 | 9/19/25 | Pending | Facet Joint Interventions |
| 2025-LHCC-1456 | Fecal Incontinence Treatments | 8/5/25 | 9/19/25 | Pending | Fecal Incontinence Treatments |
| 2025-LHCC-1457 | Neuromuscular Electrical Stimulation | 8/5/25 | 9/19/25 | Pending | Neuromuscular Electrical Stimulation |
| 2025-LHCC-1506 | Never Paid Events | 8/5/25 | 9/19/25 | Pending | Never Paid Events |
| 2025-HUM-1539 | Crisis Intervention - Follow Up | 8/5/25 | 9/19/25 | Pending | Crisis Intervention - Follow Up |
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