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| Item Number | Policy/Procedure | Date Posted | Comment Period Closed | Status | Document Links |
|---|---|---|---|---|---|
| 2025-UHC-311 | Transcatheter Heart Valve Procedures | 4/22/25 | 6/6/25 | Pending | Transcatheter Heart Valve Procedures |
| 2025-ABH-822 | ABH Provider Manual | 4/22/25 | 6/6/25 | Pending | ABH Provider Manual |
| 2025-LHCC-1416 | Transportation Policy | 4/22/25 | 6/6/25 | Pending | Transportation Policy |
| 2025-UHC-1432 | Pediatric Gait Trainers and Standing Systems | 4/22/25 | 6/6/25 | Pending | Pediatric Gait Trainers and Standing Systems |
| 2025-LHCC-1822 | Opioid Use Disorder (OUD) treatment in Opiod Treatment Programs | 4/22/25 | 6/6/25 | Pending | Opioid Use Disorder (OUD) treatment in Opiod Treatment Programs |
| 2025-LHCC-1947 | ADHD | 4/22/25 | 6/6/25 | Pending | ADHD |
| 2025-LHCC-1960 | Dually Diagnosed Continuous Improvement | 4/22/25 | 6/6/25 | Pending | Dually Diagnosed Continuous Improvement |
| 2025-HBL-2647 | Care at Home | 4/22/25 | 6/6/25 | Pending | Care at Home |
| 2025-LHCC-2651 | MediTrans - Inclement Weather | 4/22/25 | 6/6/25 | Pending | MediTrans - Inclement Weather |
| 2025-LHCC-2652 | MediTrans - Critical Incident | 4/22/25 | 6/6/25 | Pending | MediTrans - Critical Incident |
| 2025-LHCC-2653 | MediTrans - Fraud Payment Suspensions | 4/22/25 | 6/6/25 | Pending | MediTrans - Fraud Payment Suspensions |
| 2025-LHCC-2654 | MediTrans-Call Center Manual | 4/22/25 | 6/6/25 | Pending | MediTrans-Call Center Manual |
| 2025-LHCC-2655 | MediTrans -Claims Creation and Editing | 4/22/25 | 6/6/25 | Pending | MediTrans -Claims Creation and Editing |
| 2025-LHCC-2656 | MediTrans Disaster Recovery Manual | 4/22/25 | 6/6/25 | Pending | MediTrans Disaster Recovery Manual |
| 2025-LHCC-2657 | MediTrans NEMT Operations Manual | 4/22/25 | 6/6/25 | Pending | MediTrans NEMT Operations Manual |
| 2025-LHCC-2659 | MediTrans Transportation Provider Handbook | 4/22/25 | 6/6/25 | Pending | MediTrans Transportation Provider Handbook |
| 2025-LHCC-2670 | MediTrans -Out of State Trip Policy | 4/22/25 | 6/6/25 | Pending | MediTrans -Out of State Trip Policy |
| 2025-UHC-2674 | Chiropractic Services Policy | 4/22/25 | 6/6/25 | Pending | Chiropractic Services Policy |
| 2025-UHC-247 | Negative Pressure Wound Therapy | 4/2/25 | 5/17/25 | Pending | Negative Pressure Wound Therapy |
| 2025-UHC-375 | Pneumatic Compression Devices | 4/2/25 | 5/17/25 | Pending | Pneumatic Compression Devices |
| 2025-UHC-474 | Rhinoplasty and Other Nasal Procedures | 4/2/25 | 5/17/25 | Pending | Rhinoplasty and Other Nasal Procedures |
| 2025-UHC-555 | Orthognathic (Jaw) Surgery | 4/2/25 | 5/17/25 | Pending | Orthognathic (Jaw) Surgery |
| 2025-UHC-580 | Embolization Ovarian Iliac Pelvic Congestion Syndrome | 4/2/25 | 5/17/25 | Pending | Embolization Ovarian Iliac Pelvic Congestion Syndrome |
| 2025-UHC-1170 | Prostate Surgeries and Interventions | 4/2/25 | 5/17/25 | Pending | Prostate Surgeries and Interventions |
| 2025-LHCC-1214 | Total Parenteral Nutrition and Intradialytic Parental Nutrition | 4/2/25 | 5/17/25 | Pending | Total Parenteral Nutrition and Intradialytic Parental Nutrition |
| 2025-LHCC-1216 | Bariatric Surgery | 4/2/25 | 5/17/25 | Pending | Bariatric Surgery |
| 2025-LHCC-1356 | Lung Transplantation | 4/2/25 | 5/17/25 | Pending | Lung Transplantation |
| 2025-LHCC-1358 | Pancreas Transplantation | 4/2/25 | 5/17/25 | Pending | Pancreas Transplantation |
| 2025-LHCC-1360 | Heart-Lung Transplant | 4/2/25 | 5/17/25 | Pending | Heart-Lung Transplant |
| 2025-LHCC-1362 | Nonmyeloablative allogeneric SCT | 4/2/25 | 5/17/25 | Pending | Nonmyeloablative allogeneric SCT |
| 2025-LHCC-1363 | Tandem Transplant | 4/2/25 | 5/17/25 | Pending | Tandem Transplant |
| 2025-LHCC-1385 | Implantable Wireless PAP Monitoring | 4/2/25 | 5/17/25 | Pending | Implantable Wireless PAP Monitoring |
| 2025-UHC-1523 | Facet Joint and Medial Branch Block Injections for Spinal Pain | 4/2/25 | 5/17/25 | Pending | Facet Joint and Medial Branch Block Injections for Spinal Pain |
| 2025-LHCC-1527 | Nerve Blocks and Neurolysis for Pain Management | 4/2/25 | 5/17/25 | Pending | Nerve Blocks and Neurolysis for Pain Management |
| 2025-LHCC-1703 | Pediatric Kidney Transplant | 4/2/25 | 5/17/25 | Pending | Pediatric Kidney Transplant |
| 2025-LHCC-1744 | Phototherapy for Neonatal Hyperbilirubinemia | 4/2/25 | 5/17/25 | Pending | Phototherapy for Neonatal Hyperbilirubinemia |
| 2025-LHCC-1745 | Donor Lymphocyte Infusion | 4/2/25 | 5/17/25 | Pending | Donor Lymphocyte Infusion |
| 2025-LHCC-1838 | Intensity-Modulated Radiotherapy | 4/2/25 | 5/17/25 | Pending | Intensity-Modulated Radiotherapy |
| 2025-LHCC-1934 | Experimental Technologies | 4/2/25 | 5/17/25 | Pending | Experimental Technologies |
| 2025-LHCC-1935 | Gastric Electrical Stimulation | 4/2/25 | 5/17/25 | Pending | Gastric Electrical Stimulation |
| 2025-LHCC-498 | Mental Health Rehab MNC Policy | 3/27/25 | 5/11/25 | Pending | |
| 2025-ACLA-874 | CT (Virtual) Colonoscopy | 3/27/25 | 5/11/25 | Pending | |
| 2025-ACLA-877 | Chest MRA | 3/27/25 | 5/11/25 | Pending | |
| 2025-LHCC-1167 | DME Clinical Policy | 3/27/25 | 5/11/25 | Pending | |
| 2025-LHCC-1417 | Adult Crisis Stabilization | 3/27/25 | 5/11/25 | Pending | |
| 2025-LHCC-1507 | Clinical Validation of Modifier 59 | 3/27/25 | 5/11/25 | Pending | |
| 2025-LHCC-1910 | Implantable Intrathecal or Epidural Pain Pump | 3/27/25 | 5/11/25 | Pending | |
| 2025-LHCC-2236 | Concert Genetics Immune Autoimmune and Rheumatoid Disorders | 3/27/25 | 5/11/25 | Pending | |
| 2025-HBL-2573 | Prior Auth Chngs for Gndr Affrmng Care-GAC Ph III-Caid | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2621 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2622 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2623 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2624 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2625 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2626 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2627 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2628 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2629 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2630 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2631 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2632 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2633 | Drugs & Biologicals HCPCS | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2669 | Gender-Specific Services for Transgender or Intersex Members | 3/27/25 | 5/11/25 | Pending |
Gender-Specific Services for Transgender or Intersex Members |
| 2025-HBL-2671 | Genetic Testing | 3/27/25 | 5/11/25 | Pending | |
| 2025-HBL-2672 | PA Req Changes for UM AROW | 3/27/25 | 5/11/25 | Pending | |
| 2025-HUM-2673 | Drugs & Biologicals | 3/27/25 | 5/11/25 | Pending | |
| 2025-LHCC-982 | Outpatient Applied Behavior Analysis Medical Necessity | 3/19/25 | N/A | N/A | |
| 2025-UHC-222 | Skin and Soft Tissue Substitutes | 3/14/25 | 4/28/25 | Pending | Skin and Soft Tissue Substitutes |
| 2025-HBL-362 | Pediatric Day Health Care and Personal Care Services | 3/14/25 | 4/28/25 | Pending | Pediatric Day Health Care and Personal Care Services |
| 2025-UHC-490 | Cardiovascular Disease Risk Tests | 3/14/25 | 4/28/25 | Pending | Cardiovascular Disease Risk Tests |
| 2025-UHC-782 | Discogenic Pain Treatment | 3/14/25 | 4/28/25 | Pending | Discogenic Pain Treatment |
| 2025-UHC-825 | Cardiac Event Monitoring | 3/14/25 | 4/28/25 | Pending | Cardiac Event Monitoring |
| 2025-UHC-949 | Chemotherapy-Observation or Inpatient Hospitalization | 3/14/25 | 4/28/25 | Pending | Chemotherapy-Observation or Inpatient Hospitalization |
| 2025-LHCC-1480 | Pre-operative Visits | 3/14/25 | 4/28/25 | Pending | Pre-operative Visits |
| 2025-LHCC-1507 | Clinical Validation of Modifier 59 | 3/14/25 | 4/28/25 | Withdrawn | Clinical Validation of Modifier 59 |
| 2025-LHCC-1509 | Clinical Validation of Modifier 25 | 3/14/25 | 4/28/25 | Withdrawn | Clinical Validation of Modifier 25 |
| 2025-LHCC-1747 | PCS-EPSDT Policy | 3/14/25 | 4/28/25 | Pending | PCS-EPSDT Policy |
| 2025-HUM-2668 | LA MEDICAID ASC PROCEDURE MAX | 3/14/25 | 4/28/25 | Pending | LA MEDICAID ASC PROCEDURE MAX |
| 2025-LHCC-107 | UM Program Description | 3/10/25 | 4/24/25 | Pending | UM Program Description |
| 2025-LHCC-772 | Implantable Cardioverter Defibrillator (ICD) | 3/10/25 | 4/24/25 | Pending | Implantable Cardioverter Defibrillator (ICD) |
| 2025-HBL-951 | Durable Medical Equipment | 3/10/25 | 4/24/25 | Pending | Durable Medical Equipment |
| 2025-ABH-1179 | Prior Authorizations | 3/10/25 | 4/24/25 | Pending | Prior Authorizations |
| 2025-LHCC-1212 | Spinal Cord Stimulation | 3/10/25 | 4/24/25 | Pending | Spinal Cord Stimulation |
| 2025-LHCC-1218 | Ventricular Assist Devices | 3/10/25 | 4/24/25 | Pending | Ventricular Assist Devices |
| 2025-LHCC-1270 | Urinary Incontinence Devices and Treatments | 3/10/25 | 4/24/25 | Pending | Urinary Incontinence Devices and Treatments |
| 2025-LHCC-1271 | Implantable Hypoglossal Nerve Stimulation for OSA | 3/10/25 | 4/24/25 | Pending | Implantable Hypoglossal Nerve Stimulation for OSA |
| 2025-LHCC-1379 | Inhaled Niric Oxide | 3/10/25 | 4/24/25 | Pending | Inhaled Niric Oxide |
| 2025-LHCC-1403 | Continuuity and Coordination of Medical Care | 3/10/25 | 4/24/25 | Pending | Continuuity and Coordination of Medical Care |
| 2025-HUM-1531 | ABA Clinical Coverage | 3/10/25 | 4/24/25 | Pending | ABA Clinical Coverage |
| 2025-HUM-1593 | Provider Manual | 3/10/25 | 4/24/25 | Pending | Provider Manual |
| 2025-HUM-1818 | Functional Family Therapy (FFT) | 3/10/25 | 4/24/25 | Pending | Functional Family Therapy (FFT) |
| 2025-LHCC-1819 | Burn Surgery | 3/10/25 | 4/24/25 | Pending | Burn Surgery |
| 2025-LHCC-1821 | Selective Dorsal Rhizotomy for Spasticity in CP | 3/10/25 | 4/24/25 | Pending | Selective Dorsal Rhizotomy for Spasticity in CP |
| 2025-LHCC-1825 | Proton and Neutron Beam Therapies | 3/10/25 | 4/24/25 | Pending | Proton and Neutron Beam Therapies |
| 2025-LHCC-1837 | Obstetrical Home Care Programs | 3/10/25 | 4/24/25 | Pending | Obstetrical Home Care Programs |
| 2025-LHCC-1907 | Hyperhidrousis Treatments | 3/10/25 | 4/24/25 | Pending | Hyperhidrousis Treatments |
| 2025-UHC-1941 | Louisiana ABA Policy | 3/10/25 | 4/24/25 | Pending | Louisiana ABA Policy |
| 2025-LHCC-1948 | Implantable Loop recorder | 3/10/25 | 4/24/25 | Pending | Implantable Loop recorder |
| 2025-LHCC-2354 | ID Respiratory Lab Testing | 3/10/25 | 4/24/25 | Pending | ID Respiratory Lab Testing |
| 2025-LHCC-2612 | Multiple ER Visits, Same Day | 3/10/25 | 4/24/25 | Pending | Multiple ER Visits, Same Day |
| 2025-LHCC-2613 | 30 Day Readmission | 3/10/25 | 4/24/25 | Pending | 30 Day Readmission |
| 2025-LHCC- 2614 | Leveling of ER Services | 3/10/25 | 4/24/25 | Pending | Leveling of ER Services |
| 2025-ABH-2645 | Treatment at Home In Lieu of Service | 3/10/25 | 4/24/25 | Pending | Treatment at Home In Lieu of Service |
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