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Continues the provisions of the March 23, 2020 Emergency Rule which amended the provisions governing the dental benefits prepaid ambulatory health plan in order to increase reimbursement rates for dental exams for children under three years of age and restorative dental services, in compliance with Act 10 of the 2019 Regular Session of the Louisiana Legislature.
Amends the provisions governing children and adult mental health services in order to update the Rule language to reflect current terminology and practices and to change the treatment plan review requirement.
Amends the provisions governing the facility need review (FNR) process in order to allow the department to approve a one-time partial relocation/transfer of a nursing facility’s Medicaid FNR approvals to another licensed, certified, and operational nursing facility within the same parish under certain conditions.
Amends the provisions governing the licensing of hospitals in order to allow an exception to the requirement that the level of care on the neonatal intensive care unit match or exceed the level of obstetrical care for each level of obstetric service for any hospital which has a current cooperative endeavor agreement linking the hospital to a public–private partnership with the state.
Adopts provisions governing routine care for recipients in clinical trials in order to clarify the requirements for reimbursement for medically necessary non-experimental/investigational treatments that recipients participating in clinical trials would otherwise receive under the Louisiana Medicaid program.
Amends the provisions governing telemedicine in order to clarify that there are no limitations as to the telemedicine originating site.
Amends the provisions governing nursing facility reimbursements in order to mandate the use of the optional state assessment item set to replace Medicare prospective payment system assessments retired by CMS due to the implementation of the patient driven payment model.
Continues the provisions of the December 27, 2019 Emergency Rule which amended the provisions governing provider enrollment in the non-emergency medical transportation (NEMT) program in order to lower the minimum liability insurance coverage requirements and reduce insurance premiums paid by NEMT providers to sustain and increase provider participation in the NEMT program and removed language referring to prepayment of premiums from the administrative Rule to align with current practices.
Amends the provisions governing transfers of assets in the Medical Assistance Program to allow for the imposition of a penalty period for individuals applying for, or receiving HCBS, who transfer assets for less than fair market value, in compliance with requirements of the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Amends the provisions governing the licensing standards for behavioral health service providers in order to provide further definitions and provisions related to geographic service area and to update the facility need approval definition to align with current practice regarding the requirement for a letter of approval from the Facility Need Review Committee for applicants who seek to provide psychosocial rehabilitation or community psychiatric support and treatment services.
Continues the provisions of the September 20, 2019 and December 20, 2019 Emergency Rules which adopted provisions governing the licensing of therapeutic group homes (TGHs) in order to comply with federal criminal background check and Department of Children and Family Services abuse/neglect registry check requirements.
Amends the provisions governing reimbursement in the Pharmacy Benefits Management Program in order to add vaccines for adult recipients as a pharmacy benefit to provide an alternative location for these recipients to received necessary vaccinations and immunizations.