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-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

RELATED INFO

Surgeon General Ralph L. Abraham, M.D.

Secretary Bruce D. Greenstein

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