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| Certification Date | Original Period Certified | Actual Period Covered |
|
June 21, 2024 |
July 2024 - June 2025 | Present Period |
|
February 14, 2024 |
January - June 2024 | January - June 2024 |
|
December 6, 2023 |
July 2023 - June 2024 | July 2023 - December 2023 |
|
June 23, 2023 |
July 2023 - June 2024 | Replaced by December 6, 2023 certification |
| December 16, 2022 | January – June 2023 | January 2023 – June 2023 |
Rate Certification Letters
About Rate Certification Letters
- The Louisiana Department of Health (LDH) has contracted with Milliman, Inc. to develop actuarially sound capitation rate ranges for the Healthy Louisiana program (formerly Bayou Health).
- Rate certification letters certify universal rates for a given time period, e.g., a state fiscal year. Rates shown in these letters are not the rates actually paid to participating Managed Care Organizations (MCO), as the actual rates paid to each MCO are risk-adjusted. That is, the rates paid to each MCO are the universal rates in the rate letter as adjusted for the expected costs of that MCO’s enrolled members, based on the members’ health conditions and health status.
- Original rate letters are often replaced with revised rate letters for the same time period. Revisions are necessary whenever there are programmatic changes (e.g., changes in services or populations covered) that impact rates effective within the original rate letter time period. Revisions may cover the entire period or only part of the period (going forward from the effective date of a program change prior to the end the period).
- Sometimes a rate letter is supplemented with an issue-specific companion certification. For example, the Affordable Care Act (ACA) Primary Care Physician (PCP) enhanced payment, which was an add-on to PMPMs paid in 2013 and 2014 as required by Section 1202 of the Affordable Care Act, had its own certification letter.
NOTES FOR UNDERSTANDING THE TABLES BELOW:
* All published rate certifications are provided in the tables below.
* The currently active rate certification is displayed in boldface text .
* Any rate certification that was subsequently revised and superseded by another rate certification is noted with the date of the replacement certification in the column labeled “Actual Period Covered” and shaded in light gray.
* When the “Actual Period Covered” differs from the “Original Period Certified,” the revised end date for the “Actual Period Covered” is displayed in italic text.
Healthy Louisiana 3.0 (January 2023 – present)
Risk-bearing MCO Rate Certification Letters
Healthy Louisiana / Bayou Health 2.0 (February 2015 – December 2022)
Risk-bearing MCO Rate Certification Letters
| Certification Date | Original Period Certified | Actual Period Covered |
| August 22, 2023 | July 2022 – June 2023 |
July 2022 – December 2022 |
| April 25, 2022 | January 2022 - December 2022 |
January 2022 - June 2022 Addendum for Hospital-Based Physician FMP |
| December 20, 2021 | January 2022 - December 2022 |
January 2022 - June 2022 Addendum for Act 421 Children's Medicaid Option |
| December 15, 2021 | January 2022 - December 2022 | January 2022 – June 2022 |
| November 15, 2021 | January 2022 - December 2022 | Replaced by December 15, 2021 certification |
| July 21, 2021 | January 2021 - December 2021 |
January 2021 - December 2021 |
| January 14, 2021 | January 2021 – December 2021 |
Replaced by July 21, 2021 certification |
| August 12, 2020 | July 2020 – December 2020 |
July 2020 – December 2020 Expansion and Non-Expansion Rate Certification Addendum |
| December 23, 2019 | January 2020 – December 2020 |
January 2020 - July 2020 |
| August 5, 2019 | July 2019 – December 2019 |
July 2019 – December 2019 EXPANSION Age 19-64 EXPANSION High Needs |
| August 5, 2019 | July 2019 – December 2019 | July 2019 – December 2019
NON-EXPANSION EXPANSION (SBH & Kicks) |
| May 24, 2019 | April 2019 – December 2019 |
April 2019 – June 30, 2019 EXPANSION Age 19-64 EXPANSION High Needs |
| May 22, 2019 | April 2019 – December 2019 |
April 2019 – June 30, 2019 NON-EXPANSION EXPANSION (SBH & Kicks) |
| February 6, 2019 | January 2019 – December 2019 |
January 2019 – March 31, 2019 NON-EXPANSION EXPANSION (SBH & Kicks) |
| January 28, 2019 | January 2019 – March 2019 |
January 2019 – March 31, 2019 EXPANSION Age 19-64 EXPANSION High Needs |
| December 18, 2018 | July 2018 – January 2019 | July 2018 – December 2018 |
| August 24, 2018 | May 2018 – January 2019 | May 2018 –June 2018 |
| August 24, 2018 | February 2018 – April 2018 | February 1, 2018 – April 30, 2018 |
| July 9, 2018 | February 2018 – April 2018 | Replaced by August 24, 2018 certification |
| July 9, 2018 | October 2017 – January 2018 | October 1, 2017 – January 31, 2018 |
| July 9, 2018 | February 2017 – January 2018 | March 1, 2017 – September 30, 2017 |
| June 19, 2018 | May 2018 – January 2019 | Replaced by August 24, 2018 certification |
| April 30, 2018 | February 2018 – January 2019 | Replaced by July 9, 2018 certification |
| March 5, 2018 | February 2018 – January 2019 | Replaced by April 30, 2018 certification |
| January 22, 2018 | February 2018 – January 2019 | Replaced by March 5, 2018 certification |
| January 8, 2018 | October 2017 – January 2018 | Replaced by July 9, 2018 certification |
| March 13, 2017 | February 2017 – January 2018 | February 1, 2017 – February 28, 2017 |
| February 17, 2017 | December 2015 | December 2015 SPECIALIZED BEHAVIORAL HEALTH |
| February 17, 2017 | December 2015 | December 2015 NEMT SERVICES |
| February 17, 2017 | December 2015 | December 2015 PHYSICAL HEALTH |
| February 17, 2017 | July 2015 – November 2015 | July 1, 2015 – November 30, 2015 |
| February 17, 2017 | February 2015 – June 2015 |
February 1, 2015 – June 30, 2015 |
| September 13, 2016 | December 2015 – January 2016 | January 2016 SPECIALIZED BEHAVIORAL HEALTH |
| September 13, 2016 | December 2015 – January 2016 | January 2016 NEMT SERVICES |
| December 2015 – January 2016 | January 2016 PHYSICAL HEALTH |
|
| September 12, 2016 | July 2016 – January 2017 | July 1, 2016 – January 31, 2017 NON-EXPANSION |
| September 12, 2016 | February 2016 – January 2017 | February 1, 2016 – June 30, 2016 |
|
July 2016 – January 2017 |
July 1, 2016 – January 31, 2017 |
|
|
February 2016 – January 2017 |
Replaced by September 12, 2016 certification |
|
|
December 2015 – January 2016 |
Replaced by February 17, 2017 certification |
|
|
December 2015 – January 2016 |
Replaced by February 17, 2017 certification |
|
|
December 2015 – January 2016 |
Replaced by February 17, 2017 certification |
|
|
July 2015 – January 2016 |
Replaced by February 17, 2017 certification |
|
|
February 2015 – January 2016 |
Replaced by February 17, 2017 certification |
|
|
July 2015 – January 2016 |
Replaced by October 12, 2015 certification |
|
|
February 2015 – January 2016 |
Replaced by October 15, 2015 certification |
|
|
February 2015 – January 2016 |
Replaced by January 31, 2015 certification |
Family Planning Addendum
| Certification Date | Original Period Certified | Actual Period Covered |
|
February 2016 – January 2017 |
February 1, 2016 - present |
|
|
February 2015 – January 2016 |
February 1, 2015 – January 31, 2016 |
Bayou Health 1.0 (February 2012 – January 2015)
Prepaid Rate Certification Letters
| Certification Date | Original Period Certified | Actual Period Covered |
|
September 2014 – January 2015 |
September 1, 2014 – January 31, 2015 |
|
|
July 2014 – August 2014 |
July 1, 2014 – August 31, 2014 |
|
|
April 2014 – June 2014 |
April 1, 2014 – June 30, 2014 |
|
|
September 2014 – January 2015 |
Not applicable |
|
|
July 2014 – January 2015 |
Not applicable |
|
|
January 2014 – June 2014 |
January 1, 2014 – March 31, 2014 |
|
|
July 2013 – December 2013 |
July 1, 2013 – December 31, 2013 |
|
|
July 2013 - December 2013 |
Not applicable |
|
|
January 2013 – June 2013 |
January 1, 2013 – June 30, 2013 |
|
|
January 2013 – June 2013 |
Not applicable |
|
|
November 2012 – December 2012 |
November 1, 2012 – December 31, 2012 |
|
|
November 2012 – December 2012 |
Not applicable |
|
|
August 2012 – December 2012 |
August 1, 2012 – October 31, 2012 |
|
|
October 2012 – December 2012 |
Not applicable |
|
|
August 2012 – December 2012 |
Not applicable |
|
|
July 2012 – December 2012 |
July 1, 2012 – July 31, 2012 |
|
|
February 2012 – December 2012 |
February 1, 2012 – June 30, 2012 |
|
|
January 2012 – December 2012 |
Not applicable |
|
|
January 2012 – December 2012 |
Not applicable |
Affordable Care Act (ACA) Primary Care Physician (PCP) Add-On
| Certification Date | Original Period Certified | Actual Period Covered |
|
July 2014 – December 2014 |
July 1, 2014 – December 31, 2014 |
|
|
January 2014 – December 2014 |
January 1, 2014 – June 30, 2014 |
|
|
January 2014 – June 2014 |
Not applicable |
|
|
July 2013 – December 2013 |
July 1, 2013 – December 31, 2013 |
|
|
January 2013 – June 2013 |
January 1, 2013 – June 30, 2013 |
Family Planning Addendum
| Certification Date | Original Period Certified | Actual Period Covered |
|
February 2015 – January 2016 |
February 1, 2015 – January 31, 2016 |
|
|
September 2014 – January 2015 |
September 1, 2014 – January 31, 2015 |
|
|
July 2014 – August 2014 |
July 1, 2014 – August 31, 2014 |
|
|
April 2014 – June 2014 |
April 1, 2014 – June 30, 2014 |
|
|
September 2014 – January 2015 |
Not applicable |
|
|
July 2014 – January 2015 |
July 1, 2014 – March 31, 2014 |
|
|
January 2014 – June 2014 |
January 1, 2014 – June 30, 2014 |
|
|
July 2013 – December 2013 |
July 1, 2013 – December 31, 2013 |
|
|
January 2013 – June 2013 |
January 1, 2013 – June 30, 2013 |
|
|
November 2012 – December 2012 |
November 1, 2012 – December 31, 2012 |
Shared Savings Benchmark Letters
| Benchmark Letter Date | Original Period | Actual Period Covered |
|
July 2014 - January 2015 |
July 1, 2014 - January 31, 2015 |
|
|
January 2014 – June 2014 |
January 1, 2014 – June 30, 2014 |
|
|
July 2013 – December 2013 |
July 1, 2013 – December 31, 2013 |
|
|
February 2013 – June 2013 |
February 1, 2013 – June 30, 2013 |
|
|
February 2013 – June 2013 |
Not applicable |
|
|
January 2013 |
January 1, 2013 – January 31, 2013 |
|
|
August 2012 - December 2012 |
August 2012 - December 2012 |
|
|
February 2012 – December 2012 |
February 2012 – July 2012 |
|
|
January 2012 – December 2012 |
Not applicable |
|
|
January 2012 – December 2012 |
Not applicable |