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LDH News

• July 10, 2024

  Medical Transportation Program – Elevated Level of Care LAC 50:XXVII.Chapter 5 and Chapter 7

  Amends the provisions governing the medical transportation program to establish guidelines for the administration and distribution of Elevated Level of Care (ELOC) services by non-emergency medical transportation (NEMT) vendors that meet the criteria to provide an elevated level of care service to Medicaid beneficiaries utilizing this service, and to clarify language regarding non-emergency medical ambulance transportation (NEAT) services.

• May 10, 2024

  Outpatient Hospital Services – High Medicaid Utilization Academic Hospitals LAC 50:V.Chapter 77

  Adopts provisions governing qualifying criteria and reimbursement methodology for high Medicaid utilization academic hospitals to increase payments for outpatient hospital services.

• May 10, 2024

  Inpatient Hospital Services – High Medicaid Utilization Academic Hospitals LAC 50:V.Chapter 22

  Adopts provisions governing qualifying criteria and reimbursement methodology for high Medicaid utilization academic hospitals to increase payments for inpatient hospital services.

• April 11, 2024

  Provider Screening and Enrollment LAC 50:I.Chapter 15

  Amends the provisions governing provider screening and enrollment in order to comply with U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services requirements to align the provisions governing out-of-state enrollment and single case agreements with the Medicaid Provider Enrollment Compendium, to codify provisions for informal hearings and appeal rights for provider enrollment denials and terminations, and to ensure that the administrative Rule is consistent with current practices.

• April 11, 2024

  Pharmacy Benefit Management Program – Excluded Drugs LAC 50:XXIX.107

  Amends the provisions governing the Pharmacy Benefit Management Program in order to align the language in the Louisiana Administrative Code relative to drugs excluded from Medicaid coverage with the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services -approved State Plan amendment.

• April 11, 2024

  Inpatient Hospital Services LAC 50:V.121, 123, 125, and 127

  Repeals inpatient hospital services Rules which were promulgated prior to implementation of the Louisiana Administrative Code (LAC) codification system and amends the provisions governing inpatient hospital services in order to promulgate the criteria to qualify for reimbursement as a distinct part psychiatric unit in a codified format in the LAC and add qualifying criteria for rehabilitation, long-term, and freestanding hospitals.

• April 11, 2024

  Children’s and Adult Mental Health Services LAC 50:XXXIII.Chapters 23, 61, 63, and 65

  Amends the provisions governing children’s and adult mental health services to expand the mental health professionals eligible to provide therapeutic services to include provisionally licensed professional counselors, provisionally licensed marriage and family therapists, and licensed master social workers.

• March 08, 2024

  Home and Community-Based Services Waivers – Community Choices Waiver LAC 50:XXI.Chapters 81, 83, 85, 86, 87, 89, 93 and 95

  Amends the provisions governing the Community Choices Waiver to update the individuals approved to be personal assistance service workers and monitored in-home caring principal caregivers, permit monitored in-home caregiving participants to receive adult day health care services simultaneously, and add financial management services as a new service when participants choose the self-direction option in order to align the administrative Rule with the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services approved waiver amendment.

• December 08, 2023

  Program of All Inclusive Care for the Elderly – Personal Care Attendant Services: LAC 50:XXIII.Chapters 1-11

  Amends the provisions governing the Program of All Inclusive Care for the Elderly (PACE) in order to require that a PACE organization/provider have a personal care attendant (PCA) home and community-based services license in addition to the required adult day health care license if the organization/provider does not contract with a PCA agency, and updates language in order to reflect current practices and terminology.

• December 08, 2023

  Ambulatory Surgical Centers – Reimbursement Methodology: LAC 50:XI.7503

  Amends the provisions governing the reimbursement methodology for ambulatory surgical centers (ASCs) in order to allow qualified ASCs to bill for services provided to Medicaid beneficiaries at the outpatient hospital rate and be reimbursed on the current Louisiana State University enhanced fee schedule.

• November 13, 2023

  Intermediate Care Facilities for Persons with Intellectual Disabilities – Leave of Absence Days: LAC 48:I.8531 and 8591

  Amends the provisions governing leave of absence days for intermediate care facilities for persons with intellectual disabilities (ICFs/IID) in order to increase the total leave days for ICF/IID clients from 45 to 60 and from 30 consecutive days in any single occurrence to 45 consecutive days.

• November 13, 2023

  Inpatient Hospital Services – Teaching Hospitals: LAC 50:V.1301 and §1303

  Amends the provisions governing inpatient hospital services to clarify the purpose of the affiliated agreement that hospitals must have with an accredited institution for major or minor teaching hospital graduation education training and the options applicable for residency programs in order to align the administrative Rule with the current State Plan Amendment approved by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.