Medicaid Managed Care Policies & Procedures Archive

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.

Below are items previously posted for public comment:

Item Number Policy/Procedure Date Posted Comment Period Closed Status Document Links
2026-ABH-2358 AMA 7100.72 CPT Vest High Frequency 5/29/2026 7/13/2026 Approved AMA XXXX CPT Vest-High Frequency Chest Wall Oscillation Device
2026-ACLA-1223 Hospice Prior Authorization 5/29/2026 7/13/2026 Approved Hospice Prior Authorization
2026-ACLA-1442 Prior Authorization Service List 5/29/2026 7/13/2026 Completed ACLA Prior Authorization Service List
2026-ACLA-1859 Nonpharmacologic Treatments for Chronic Vertigo 5/29/2026 7/13/2026 Approved Nonpharmacologic Treatments for Chronic Vertigo
2026-ACLA-1871 Three Dimensional Imaging Interpretation 5/29/2026 7/13/2026 Approved Three Dimensional Imaging Interpretation
2026-ACLA-2313 Microwave Thermotherapy Lung Kidney Tumors 5/29/2026 7/13/2026 Approved Microwave Thermotherapy Lung Kidney Tumors
2026-ACLA-2432 Air Ambulance Transport 5/29/2026 7/13/2026 Approved Air Ambulance Transport
2026-ACLA-2902 Continuous Positive Airway Pressure 5/29/2026 7/13/2026 Approved Continuous Positive Airway Pressure
2026-ACLA-2903 Hospital Services Prior Authorization 5/29/2026 7/13/2026 Approved Hospital Services Prior Authorization
2026-ACLA-2904 Outpatient Therapy Licensed Practitioners 5/29/2026 7/13/2026 Approved Outpatient Therapy Licensed Practitioners
2026-ACLA-2905 Hysterectomy 5/29/2026 7/13/2026 Approved Hysterectomy
2026-HBL-2878 Infusion Administration Facility 5/29/2026 7/13/2026 Approved Infusion Administration Facility
2026-HBL-2879 UM AROW M5341 M5503 CMBM CD 5/29/2026 7/13/2026 Approved UM AROW M5341 M5503 CMBM CD
2026-HUM-2316 Hospital-Based Care Coordination of Pregnant Members with Substance Use Disorder - In Lieu of Service 5/22/26  7/6/26 Approved Hospital-Based Care Coordination of Pregnant Members with Substance Use Disorder - In Lieu of Service
2026-ACLA-2221 Provider Quality Monitoring Strategy 5/22/26  7/6/26 Approved Provider Quality Monitoring Strategy
2026-HUM-1556 Care Management Program Description 5/22/26 7/6/26 Approved Care Management Production Description
2026-LHCC-1385 Implantable Wireless PAP Monitoring 5/22/26 7/6/26 Approved Implantable Wireless PAP Monitoring
2026-HBL-1036 Home Health Utilization Management 5/22/26 7/6/26 Approved Home Health Utilization Management
2026-LHCC-991 Concurrent Review 5/22/26 7/6/26 Approved Concurrent Review
2026-HBL-330 Case Management 5/22/26 7/6/26 Approved Case Management
2026-HBL-946 Member Appeals Core Policy 5/14/26 6/28/26 Approved Member Appeals Core Process Physical Health
2026-LHCC-1111 Thyroid Insulin Test in Ped 5/14/26 6/28/26  Approved Thyroid Hormones and Insulin Testing in Pediatrics
2026-LHCC-1113 Cardiac Biomarker Testing 5/14/26  6/28/26 Approved Cardiac Biomarker Testing
2026-LHCC-1115 Vitamin D Testing in Peds 5/14/26  6/28/26 Approved Vitamin D Testing in Children and Adolescents
2026-LHCC-1168 Allergy Testing & Therapy 5/14/26  6/28/26  Approved Allergy Testing and Therapy
2026-LHCC-1216 Bariatric Surgery 5/14/26  6/28/26  Approved Bariatric Surgery
2026-LHCC-1227 Skin and Soft Tissue Substitutes for Chronic Wounds 5/14/26  6/28/26  Approved Skin and Soft Tissue Substitutes
2026-LHCC-1279 Measure Serum 1.25 Vit D 5/14/26 6/28/26  Approved Measurement of Serum 1,25 Vitamin D
2026-LHCC-1280 EEG Headache 5/14/26 6/28/26  Approved EEG in the Evaluation of Headache
2026-LHCC-1356 Lung Transplantation 5/14/26 6/28/26  Approved  Lung Transplantation
2026-LHCC-1386 Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins 5/14/26  6/28/26  Approved Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins and Other
2026-LHCC-1387 Percutaneous LAAD Stroke Prevention 5/14/26  6/28/26  Approved Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention
2026-LHCC-1527 Nerve Blocks and Neurolysis for Pain Management 5/14/26  6/28/26  Approved Nerve Blocks and Neurolysis for Pain Management
2026-LHCC-1701 Outpatient Testing for DOA (Drugs of Use) 5/14/26  6/28/26  Approved Drugs of Use Presumptive and Definitive Testing
2026-LHCC-1703 Pediatric Kidney Transplant 5/14/26  6/28/26  Approved Pediatric Kidney Transplant
2026-LHCC-1705 Invasive and Non-Invasive Home Ventilator 5/14/26  6/28/26  Approved Home Ventilators
2026-LHCC-1706 Wireless Motility Capsule 5/14/26  6/28/26  Approved Wireless Motility Capsule
2026-LHCC-1747 PCS-EPSDT Policy 5/14/26  6/28/26  Approved PCS EPSDT Policy
2026-ABH-2351 AMA XXXX Continuous Positive Airway Pressure 5/14/26  6/28/26  Approved AMA 7100.70 Continuous Positive Airway Pressure
2026-HUM-2608 Outpatient Lactation Support ILOS 5/14/26  6/28/26  Approved Outpatient Lactation Support Provider
2026-HBL-2886 Maternity Services Comms RP 5/14/26  6/28/26  Approved Maternity Services Comms
2026-LHCC-2895 Immobilized Lipase Cartridges (RELiZORB) 5/14/26  6/28/26  Approved Immobilized Lipase Cartridges
2026-HBL-2896 UM AROW M5513 CMBM CD 5/14/26  6/28/26  Approved UM AROW M5513 CMBM CD
2026-LHCC-2829 Cardiovascular Stress Test 5/11/26 6/25/26 Approved Cardiovascular Stress Test
2026-LHCC-2830 Aortic Valve Replacement 5/11/26 6/25/26 Approved Aortic Valve Replacement
2026-LHCC-1167 DME Clinical Policy 5/11/26  6/25/26  Approved DME Clinical Policy
2026-LHCC-1217 Ultrasound in Pregnancy 5/11/26  6/25/26  Approved Ultrasound in Pregnancy
2026-LHCC-1278 Evoked Potential Testing 5/11/26  6/25/26  Approved Evoked Potential Testing
2026-LHCC-1360 Heart-Lung Transplant 5/11/26  6/25/26  Approved Heart-Lung Transplant
2026-LHCC-1745 Donor Lymphocyte Infusion 5/11/26   6/25/26  Approved Donor Lymphocyte Infusion
2026-LHCC-1838 Intensity-Modulated Radiotherapy 5/11/26   6/25/26  Approved Intensity-Modulated Radiotherapy
2026-LHCC-2232 Concert Genetics General Approach to Genetic Testing 5/11/26   6/25/26  Approved Concert Genetics General Approach to Genetic Testing
2026-LHCC-2234 Concert Genetics Lung Disorders 5/11/26   6/25/26  Approved Concert Genetics Lung Disorders
2026-LHCC-2352 ID Multisystem Lab Testing 5/11/26   6/25/26  Approved ID Multisystem Lab Testing
2026-LHCC-2355 ID Vector Borne and Tropical Disease Lab Testing 5/11/26   6/25/26  Approved ID Vector Borne and Tropical Disease Lab Testing
2026-LHCC-2357 ID Genitourinary Lab Testing 5/11/26   6/25/26  Approved ID Genitourinary Lab Testing
2026-HBL-2815 UM AROW CMBM A2026M5387 5/11/26   6/25/26  Approved UM AROW CMBM A2026M5387
2026-HBL-2876 UM AROW CMBM 5/11/26   6/25/26  Approved UM AROW CMBM
2026-LHCC-2887 Concert Genetic Testing Identity and Forensics 5/11/26   6/25/26  Approved Concert Genetic Testing Identity and Forensics
2026-LHCC-2888 Concert Genetic Testing Nutrition and Metabolism 5/11/26   6/25/26  Approved Concert Genetic Testing Nutrition and Metabolism
2026-LHCC-2889 Concert Genetic Testing Transplant 5/11/26   6/25/26  Approved Concert Genetic Testing Transplant
2026-LHCC-2890 Concert Genetic Testing Endocrinology  5/11/26   6/25/26  Approved Concert Genetic Testing Endocrinology
2026-LHCC-281 Emergency Contract Deliverable - Credentialing Committee 5/1/26 6/15/26 Approved Emergency Contract Deliverable - Credentialing Committee

Related Information

Surgeon General Evelyn Griffin, MD

Secretary Bruce D. Greenstein

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