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.




Item Number  Policy/Procedure   Date Posted  Comment Period Closed   Status Document Links
2025-UHC-510 Collagen Crosslinks and Biochemical Markers of Bone Turnover 12/23/25 2/6/26 Pending Collagen Crosslinks and Biochemical Markers of Bone Turnover
2025-UHC-827 Prolotherapy and Platelet Rich Plasma Therapies 12/23/25 2/6/26 Pending Prolotherapy and Platelet Rich Plasma Therapies
2025-UHC-948 Catheter Ablation for Atrial Fibrillation 12/23/25 2/6/26 Pending Catheter Ablation for Atrial Fibrillation
2025-UHC-961 Elective Inpatient Services 12/23/25 2/6/26 Pending Elective Inpatient Services
2025-UHC-1120 Percutaneous Patent Foramen Ovale (PFO) Closure 12/23/25 2/6/26 Pending Percutaneous Patent Foramen Ovale (PFO) Closure
2025-UHC-1785 Plagiocephaly and Craniosynostosis Treatment 12/23/25 2/6/26 Pending Plagiocephaly and Craniosynostosis Treatment
2025-UHC-222 Skin and Soft Tissue Substitutes 12/12/25 1/26/26 Pending Skin and Soft Tissue Substitutes
2025-UHC-223 Vagus and External Trigeminal Nerve Stimulation 12/12/25 1/26/26 Pending Vagus and External Trigeminal Nerve Stimulation
2025-UHC-310 Total Artificial Disc Replacement Spine – Revised 12/12/25 1/26/26 Pending Total Artificial Disc Replacement Spine – Revised
2025-UHC-579 Surgery of the Hip 12/12/25 1/26/26 Pending Surgery of the Hip
2025-UHC-782 Discogenic Pain Treatment 12/12/25 1/26/26 Pending Discogenic Pain Treatment
2025-UHC-1404 Breast Imaging for Screening and Diagnosing Cancer 12/12/25 1/26/26 Pending Breast Imaging for Screening and Diagnosing Cancer
2025-LHCC-2153 Pharmacy Lock-In Program 12/12/25 1/26/26 Pending Pharmacy Lock-In Program
2025-LHCC-2321 Pharmacy Program 12/12/25 1/26/26 Pending Pharmacy Program
2025-UHC-1178 Liposuction for Lipedema 12/11/25 1/25/26 Pending Liposuction for Lipedema
2025-UHC-1851 Whole Exome and Whole Genome Sequencing (Non-Oncology Conditions) 12/11/25 1/25/26 Pending Whole Exome and Whole Genome Sequencing
2025-UHC-1829 Pharmacogenetic Panel Testing 12/11/25 1/25/26 Pending Pharmacogenetic Panel Testing
2025-UHC-224 Visual Information Processing Evaluation and Orthoptic and Vision Therapy 12/11/25 1/25/26 Pending Visual Information Processing Evaluation and Orthoptic and Vision Therapy
2025-UHC-791 Neurophysiologic Testing and Monitoring 12/11/25 1/25/26 Pending Neurophysiologic Testing and Monitoring
2025-UHC-201 Apheresis 12/4/25 1/18/26 Pending Apheresis
2025-UHC-791 Gastrointestinal Motility Disorders Diagnosis and Treatment 12/4/25 1/18/26 Pending Gastrointestinal Motility Disorders Diagnosis and Treatment
2025-UHC-789 Minimally Invasive Procedures GERD 12/4/25 1/18/26 Pending Minimally Invasive Procedures GERD
2025-HBL-1061 Venous Angio w or w/out Stent Placement or Venous Stent Alone 12/4/25 1/18/26 Pending Venous Angio w or w/out Stent Placement or Venous Stent Alone
2025-HBL-1151 Intracytoplasmic Sperm Injection 12/4/25 1/18/26 Pending Intracytoplasmic Sperm Injection
2025-LHCC-1216 Bariatric Surgery 12/4/25 1/18/26 Pending Bariatric Surgery
2025-HUM-1643 Bariatric Surgery Clinical Coverage Policy 12/4/25 1/18/26 Pending Bariatric Surgery Clinical Coverage Policy
2025-HUM-1645 Breast Surgery Clinical Coverage Policy 12/4/25 1/18/26 Pending Breast Surgery Clinical Coverage Policy
2025-HUM-1647 Continuous Subcutaneous Insulin External Infusion Pump Clinical Coverage Policy 12/4/25 1/18/26 Pending Continuous Subcutaneous Insulin External Infusion Pump Clinical Coverage Policy
2025-HUM-1652 Genetic Testing for Breast and Ovarian Cancer, FAP, and Lynch Syndrome Clinical Coverage Policy 12/4/25 1/18/26 Pending Genetic Testing for Breast and Ovarian Cancer, FAP, and Lynch Syndrome Clinical Coverage Policy
2025-HUM-1653 Hearing Aids Clinical Policy 12/4/25 1/18/26 Pending Hearing Aids Clinical Policy
2025-HUM-1654 High Frequency Chest Wall Oscillation Devices Clinical Coverage Policy 12/4/25 1/18/26 Pending High Frequency Chest Wall Oscillation Devices Clinical Coverage Policy
2025-HUM-1659 Inhaled Nitric Oxide Clinical Coverage Policy 12/4/25 1/18/26 Pending Inhaled Nitric Oxide Clinical Coverage Policy
2025-HUM-1660 Intrathecal Baclofen Therapy Clinical Coverage Policy 12/4/25 1/18/26 Pending Intrathecal Baclofen Therapy Clinical Coverage Policy
2025-HUM-1662 Osteogenic Bone Growth Stimulators 12/4/25 1/18/26 Pending Osteogenic Bone Growth Stimulators
2025-UHC-1737 Computer-Assisted Surgical Navigation for Musculoskeletal Procedures 12/4/25 1/18/26 Pending Computer-Assisted Surgical Navigation for Musculoskeletal Procedures
2025-UHC-1846 Interspinous Fusion and Decompression Devices 12/4/25 1/18/26 Pending Interspinous Fusion and Decompression Devices
2025-HBL-2191 Digital Therapy Devices for Treatment of Amblyopia 12/4/25 1/18/26 Pending Digital Therapy Devices for Treatment of Amblyopia
2025-UHC-2301 Molecular Oncology Companion Diagnostic Testing 12/4/25 1/18/26 Pending Molecular Oncology Companion Diagnostic Testing
2025-HUM-2601 Transcranial Magnetic Stimulation (TMS) 12/4/25 1/18/26 Pending Transcranial Magnetic Stimulation (TMS)
2025-LHCC-2742 ILOS LA.FINC. 12/4/25 1/18/26 Pending ILOS LA.FINC.
2025-HUM-2770 Tecelra (afamitresgene autoleucel) 12/4/25 1/18/26 Pending Tecelra (afamitresgene autoleucel)
2025-HUM-2771 Zevaskyn (prademagene zamikeracel) 12/4/25 1/18/26 Pending Zevaskyn (prademagene zamikeracel)
2025-HUM-2772 Rethymic (allogeneic processed thymus tissue-agdc) 12/4/25 1/18/26 Pending Rethymic (allogeneic processed thymus tissue-agdc)
2025-HBL-2776 Outpatient Intravenous Insulin Therapy 12/4/25 1/18/26 Pending Outpatient Intravenous Insulin Therapy
2025-HBL-2777 Home Video-Assisted Robotic Rehabilitation Systems 12/4/25 1/18/26 Pending Home Video-Assisted Robotic Rehabilitation Systems
2025-HUM-2779 Allograft Nerve Repair 12/4/25 1/18/26 Pending Allograft Nerve Repair
2025-HBL-2780 Genicular Procedures for Treatment of Knee Pain 12/4/25 1/18/26 Pending Genicular Procedures for Treatment of Knee Pain
2025-LHCC-427 Doula Services (ILO) 12/4/25 1/18/26 Pending Doula Services (ILO)
2025-ABH-2351 AMA XXXX Continuous Positive Airway Pressure 12/4/25 1/18/26 Pending AMA XXXX Continuous Positive Airway Pressure
2025-HUM-2737 Modifiers 12/4/25 1/18/26 Pending Modifiers
2025-HUM-2759 Correct coding 12/4/25 1/18/26 Pending Correct coding
2025-HUM-2760 HCPCS 12/4/25 1/18/26 Pending HCPCS

RELATED INFO

Surgeon General Evelyn Griffin, MD

Secretary Bruce D. Greenstein

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