Act 421 Children's Medicaid Option (421-CMO)

Act 421-CMO of the 2019 Regular Legislative Session provides for a program through which children with disabilities can access Medicaid-funded services regardless of their parents' income. This program furnishes Medicaid benefits to children with disabilities who are otherwise ineligible for such benefits because the income of their household exceeds state-established limits for Medicaid eligibility.

Act 421-CMO is modeled after The Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982, which is a United States federal law that can help families with children younger than 19 years old who have a disability receive care in their homes rather than an institution.

In Louisiana, this Medicaid eligibility program is called the Act 421 Children’s Medicaid Option. This optional Medicaid eligibility proposal is subject to approval by the Centers for Medicare and Medicaid Services (CMS).  Act 421-CMO is ready for implementation upon approval from CMS.


In order to be eligible for the Act 421 Children’s Medicaid Option, a child must meet all of the following eligibility criteria:

  • Be a Louisiana resident.
  • Be a United States citizen or qualified non-citizen.
  • Under the age of 19 (not to exceed the age of 18).
  • Ineligible for Medicaid coverage when the income of the child’s parents is considered.
  • Has or has applied for a Social Security Number.
  • Excluding the assets (resources) of parents, the child does not have total assets (resources) exceeding $2,000 in value.
  • The child meets an institutional level of care provided in a hospital, skilled nursing facility, or intermediate care facility (ICF).
  • Care can be provided safely at home for less than the cost of institutional care.

Act 421-CMO Registration Portal

***Coming Soon***

Frequently Asked Questions

Act 421 Children’s Medicaid Option Summary

Act 421 - Children's Medicaid Option

Act 421 Children’s Medicaid Option Demonstration Application

Get Involved

The Louisiana Department of Health wants input from parents and advocates as we continue to work to develop Act 421 Children’s Medicaid Option. Email if you’re interested in joining a stakeholder work group.



Contact Us


Mail:        Louisiana Department of Health

                Medicaid Act 421-CMO

                P.O. Box 91030, Bin 24

                Baton Rouge, LA 70821-9030