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Medicaid State Plan Amendments 2013
In compliance with Act 212 of the 2013 Regular Session of the Louisiana Legislature, LDH has made State Plan amendments (SPA) available for public view dating back to July 1, 2013. Since the date of implementation, the Department has posted pending SPAs. Some amendments are still pending from prior years, others have been approved since July 1, 2013 and posted to the site. It should be noted that the SPAs are listed by calendar year as they are created under transmittal numbers indicating the year and chronological order of creation during that year. SPAs approved prior to July 1, 2013 can be found within the main text of the comprehensive State Plan.
13-16A Behavioral Health Supplemental Payments *APPROVED*
- Initial Submittal - March 27, 2013
- RAI - June 20, 2013
- RAI Response - April 22, 2014
- CMS Approval - June 30, 2014
13-20 In-Patient Hospitals Public Private Partnership Rate for OLOL *APPROVED*
- Initial Submittal - May 16, 2013
- CMS Approval - June 23, 2013
13-21 Outpatient Hospitals Public Private Partnership Rate for OLOL *APPROVED*
- Initial Submittal - May 16, 2013
- CMS Approval - July 23, 2013
13-23 Supplemental Medicaid Inpatient Hospital Payments to Public-Private Partnerships in New Orleans and Lafayette *DISAPPROVED*
- Initial Submittal - June 27, 2013
- RAI - September 4, 2013
- RAI Response - September 6, 2013
- RAI Withdrawal Letter - November 21, 2013
- CMS Disapproval - May 2, 2014
- Request for Reconsideration - June 27, 2014
- CMS Response to Letter from Secretary - August 26, 2014
- DISALLOWANCE LA/2014/001/MAP - December 23, 2014
- Department's Request for Reconsideration of the Disallowance - February 20, 2015
- CMS Reconsideration Decision Notice - April 21, 2015
13-24 Supplemental Medicaid Outpatient Hospital Payments to Public-Private Partnerships in Lafayette *WITHDRAWN*
- Initial Submittal - June 27, 2013
- RAI - September 12, 2013
- Withdrawal - June 5, 2014
13-25 DSH Inpatient Hospital Payments to Public-Private Partnership in New Orleans, Lafayette, Houma and Lake Charles *DISAPPROVED*
- Initial Submittal - June 27, 2013
- RAI - September 4, 2013
- RAI Response - September 6, 2013
- RAI Withdrawal Letter - November 21, 2013
- CMS Disapproval - May 2, 2014
- Request for Reconsideration - June 27, 2014
- CMS Response to Letter from Secretary - August 26, 2014
- DISALLOWANCE LA/2014/001/MAP - December 23, 2014
- Department's Request for Reconsideration of the Disallowance - February 20, 2015
- CMS Reconsideration Decision Notice - April 21, 2015
13-27 Behavioral Health Reimbursement Methodology (In-Patient) *APPROVED*
- Initial Submittal - June 27, 2013
- RAI - September 4, 2013
- RAI Response - September 26, 2013
- CMS Approval - December 2, 2013
13-28 DSH Inpatient Hospital Payments to Public-Private Partnership in Shreveport, Monroe, Bogalusa and Alexandria *DISAPPROVED*
- Initial Submittal - July 12, 2013
- RAI - Septemer 5, 2013
- RAI Response - September 20, 2013
- RAI Withdrawal Letter - November 21, 2013
- CMS Disapproval - May 2, 2014
- Request for Reconsideration - June 27, 2014
- CMS Response to Letter from Secretary - August 26, 2014
- DISALLOWANCE LA/2014/001/MAP - December 23, 2014
- Department's Request for Reconsideration of the Disallowance - February 20, 2015
- CMS Reconsideration Decision Notice - April 21, 2015
13-30 Out-Patient Hospitals-NR, NS Public Hospitals-Supplemental Payments *APPROVED*
- Initial Submittal - August 23, 2013
- RAI - November 21, 2013
- CMS Approval - January 28, 2014
13-31 Professional Services Program - Public / Private Partnerships - Professional Practitioners Supplemental Payments *WITHDRAWN*
- Initial Submittal - September 16, 2013
- RAI - December 3, 2013
- Withdrawal - June 5, 2014
13-36 Professional Services Program - Physician Services - Reimbursement Methodology *APPROVED*
- Initial Submittal - September 24, 2013
- CMS Approval - December 5, 2013
13-38 Behavioral Health Services - Physician Reimbursement Methodology (Out-patient) *APPROVED*
- Initial Submittal - September 26, 2013
- RAI - Decmber 12, 2013
- RAI Response - May 23, 2014
- CMS Approval - July 24, 2014
13-39 DSH - Federally Mandated Statutory Hospitals *APPROVED*
- Initial Submittal - October 31, 2013
- CMS Approval - January 24, 2014
13-41 Behavioral Health Services - Reimbursement Methodology (In-patient) *APPROVED*
- Initial Submittal - September 26, 2013
- CMS Approval - December 2, 2013
13-43 ICF-DD Public Facilities, Reimbursement Methodology *APPROVED*
- Initial Submittal - October 31, 2013
- RAI - January 27, 2014
- RAI Response - May 13, 2014
- CMS Approval - July 23, 2014
13-44 Pharmacy Benefits Management Program - State Supplemental Rebate Agreement Program *APPROVED*
- Initial Submittal - December 30, 2013
- CMS Approval - March 14, 2014
13-45 Third Party Liability - Provider Billing and Trauma Recovery (Pursuit of Difference) *APPROVED*
- Initial Submittal - November 26, 2013
- CMS Approval - February 19, 2014
13-47 Hospice Services *APPROVED*
- Initial Submittal - December 30, 2013
- RAI - March 25, 2014
- RAI Response - May 21, 2014
- CMS Approval - July 17, 2014
13-48 Inpatient Hospital Services - NR, NS Supplemental Payments Pool Reduction *APPROVED*
- Initial Submittal - December 5, 2013
- RAI - March 4, 2014
- RAI Response - March 25, 2014
- CMS Approval - April 2, 2014
13-0049 MAGI Mandatory Eligibility Groups (Group 1) *APPROVED*
- Initial Submittal - December 27, 2013
- CMS Approval - March 6, 2014
13-0050 Eligibility Process (Group 2) *APPROVED*
- Initial Submittal - December 27, 2013
- CMS Approval - March 13, 2014
13-0051 MAGI Income Methodology (Group 3) *APPROVED*
- Initial Submittal - December 27, 2013
- CMS Approval - March 26, 2014
13-0052 Single State Agency (Group 4) *APPROVED*
- Initial Submittal - December 27, 2013
- RAI - March 26, 2014
- RAI Response - May 5, 2014
- CMS Approval - July 15, 2014
13-0053 State Residency (Group 5) *APPROVED*
- Initial Submittal – December 27, 2013
- CMS Approval – March 6, 2014
13-0054 Citizenship & Immigration Status (Group 6) *APPROVED*
- Initial Submittal – December 27, 2013
- CMS Approval – March 6, 2014
13-0055 Hospital Presumptive Eligibility (Group 7) *APPROVED*
- Initial Submittal - December 27, 2013
- CMS Approval - March 13, 2014
13-56 Medicaid Eligibility for Pregnant Unmarried Minors (PUM) or Minor Unmarried Mothers (MUM) *APPROVED*
- Initial Submittal - December 27, 2013
- CMS Approval - February 12, 2014
13-57 Exclusion of Income of Children Up to 142 Percent of the Federal Poverty Limit *APPROVED*
- Initial Submittal - December 27, 2013
- CMS Approval - February 12, 2014