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LDH News

• November 08, 2019

  Federally Qualified Health Centers - Reimbursement Methodology - Mammography Separate Payments LAC 50:XI.10703

  Amends the reimbursement methodology for federally qualified health centers in order to repeal the provisions of the December 20, 2018 Rule, which allowed a separate payment outside of the prospective payment system rate for mammography screening and diagnosis services, due to the disapproval of the corresponding State Plan Amendment by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.

• October 10, 2019

  Behavioral Health Services – Treatment for Opioid Use Disorder in Opioid Treatment Programs LAC 50:XXXIII.Chapters 151-157

  Adopts provisions governing medication-assisted opioid use disorder (OUD) treatment in Opioid Treatment Programs, for Medicaid-eligible recipients ages 18 and over, diagnosed with OUD.

• October 10, 2019

  Intermediate Care Facilities for Persons with Intellectual Disabilities – Dedicated Program Funding Pool Payments LAC 50:VII.32917

  Adopts provisions governing reimbursement to non-state intermediate care facilities for individuals with intellectual disabilities to allow one-time, lump sum payments from the dedicated program funding pool in compliance with Act 50 of the 2019 Regular Session of the Louisiana Legislature.

• October 10, 2019

  Intermediate Care Facilities for Persons with Intellectual Disabilities – Reimbursement Methodology – Direct Care Floor LAC 50:VII.32901

  Amends the provisions governing reimbursement for intermediate care facilities for individuals with intellectual disabilities in order to correct an invalid citation in the direct care floor language and ensure that these provisions are appropriately promulgated in the Louisiana Administrative Code.

• October 10, 2019

  Medicaid Eligibility – Modified Adjusted Gross Income Groups LAC 50:III.10307

  Amends the provisions governing Medicaid eligibility for modified adjusted gross income (MAGI) groups and income factors in order to clarify and align these provisions with current Federal regulations relative to the calculation of household income.

• October 10, 2019

  Medication Attendant Certified – Licensing Standards

  Amends the provisions governing the licensing of individuals certified by the department to administer medications to nursing facility residents, medication attendants certified (MACs), in order to revise and update the MAC training and certification requirements.

• October 10, 2019

  Pharmacy Benefits Management Program – Dispense as Written Electronic Prescribing LAC 50:XXIX.Chapters 1,5,7,9 and 11

  Amends the provisions governing the Pharmacy Benefits Management Program in order to allow notation of the medical necessity of brand drugs using electronic prescriptions, to allow the state to pursue outcomes-based agreements with manufacturers, and to align the provisions with the current Medicaid State Plan.

• September 11, 2019

  Inpatient Hospital Services – Non-Rural, Non-State Hospitals – Reimbursement Rate Adjustment LAC 50:V.Chapters 5 and 9

  Amends the provisions governing the reimbursement methodology for inpatient hospital services in order to adjust the reimbursement rates in compliance with House Concurrent Resolution 5 of the 2019 Regular Session of the Louisiana Legislature.

• September 11, 2019

  Outpatient Hospital Services - Non-Rural, Non-State Hospitals - Reimbursement Rate Adjustment LAC 50:V.Chapters 53-61

  Amends the provisions governing the reimbursement methodology for outpatient hospital services in order to adjust the reimbursement rates in compliance with House Concurrent Resolution 5 of the 2019 Regular Session of the Louisiana Legislature.

• September 11, 2019

  Medicaid Eligibility - Medicare Savings Programs LAC 50:III.10703 and 10705

  Amends the provisions governing financial eligibility in the Medical Assistance Program in order to disregard all resources of aged, blind and disabled individuals in all MSP eligibility determinations.

• September 11, 2019

  Managed Care for Physical and Behavioral Health – Reimbursement Methodology – Kick and Lump Sum Payments LAC 50:I.3509

  Amends the provisions governing managed care organizations (MCOs) reimbursement to allow for expansion of the current kick payment methodology to include reimbursements for specific care events, services, and treatments in addition to obstetrical deliveries and for reimbursement of the MCO monthly capitation and kick payments in the aggregate on a lump sum basis when administratively necessary.

• September 11, 2019

  Home and Community - Based Services Waivers - Residential Options Waiver LAC 50:XXI.Chapters 161, 163 and §16901

  Amends the provisions governing the Residential Options Waiver (ROW) in order to restore the minimum age for access to the ROW and delete the grandfather clause for participants under age 21, add the monitored in-home caregiving service, change units for specific services to a 15 minute rate and clarify and align provisions of the ROW with other Office for Citizens with Developmental Disabilities home and community-based services waivers.