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LDH News

• April 10, 2015

  Home Health Program - Rehabilitation Services - Reimbursement Rate Increase (LAC 50:XIII.Chapter 9)

  Amends the provisions governing rehabilitation services covered under the Home Health Program in order to increase the reimbursement rates for physical and occupational therapy services for recipients under the age of 21, and to discontinue the automatic enhanced rate adjustment for these services. This proposed Rule also repeals the June 20, 1997, May 20, 2001, and the May 20, 2004 Rules governing rehabilitation services covered in the Home Health Program, and revises and repromulgates the provisions in a codified format for inclusion in the Louisiana Administrative Code.

• April 10, 2015

  Nursing Facilities - Standards for Payment - Level of Care Determinations (LAC 50:II.10156)

  Continues the provisions of the July 20, 2014 Emergency Rule which amended the provisions governing the nursing facility standards for payment in order to clarify the level of care pathways provisions.

• April 10, 2015

  Professional Services Program - Immunizations - Reimbursement Methodology (LAC 50:IX.8305 and 8505)

  Continues the provisions of the January 1, 2013 and February 20, 2013 Emergency Rules which amended the provisions governing the reimbursement methodology for Medicaid payments to providers for the administration of certain vaccines to increase the reimbursement rates.

• April 10, 2015

  Professional Services Program - Physician Services - Reimbursement Methodology (LAC 50:IX.15113)

  Continues the provisions of the September 20, 2014 Emergency Rule which amended the provisions governing the reimbursement methodology for physician services in order to increase the reimbursement rates, revise the payment methodology, and to correct the formatting of these provisions.

• April 10, 2015

  State Children’s Health Insurance Program - LaCHIP Affordable Plan Benefits Administration (LAC 50:III.Chapter 205)

  Amends the April 2008 Rule in order to transfer the administration of health care services covered under the LaCHIP Affordable Plan (Phase 5) to the health plans participating in the BAYOU HEALTH Program, and the administration of behavioral health services to the Statewide Management Organization in the Louisiana Behavioral Health Partnership. This proposed Rule also revises the cost sharing provisions in order to remove the co-payment, co-insurance, and deductible requirements since they will no longer be attributable to the LaCHIP Affordable Plan Program.

• April 10, 2015

  State Children’s Health Insurance Program - Modified Adjusted Gross Income (LAC 50:III.20103)

  Continues the provisions of the December 31, 2013 and April 20, 2014 Emergency Rules which amended the provisions governing Medicaid eligibility to adopt the Modified Adjusted Gross Income (MAGI) eligibility methodology in the Louisiana Children’s Health Insurance Program (LaCHIP).

• April 10, 2015

  Therapeutic Group Homes - Licensing Standards (LAC 48:I.Chapter 62)

  Continues the provisions of the July 20, 2014 Emergency Rule which amended the provisions governing TGH licensing standards to revise the current TGH licensing regulations.

• March 11, 2015

  Medicaid Eligibility – Provisional Medicaid Program (LAC 50:III.2305)

  Continues the provisions of the March 20, 2015 Emergency Rule which amended the provisions of the February 9, 2014 Emergency Rule which adopted provisions to provide Medicaid-only benefits to eligible individuals who meet the income and resource requirements for Supplemental Security Income (SSI) cash assistance.

• March 11, 2015

  Professional Services Program – Physician Services – Reimbursement Rate Adjustment (LAC 50:IX.15113)

  Amends the provisions governing the reimbursement methodology for physician services in order to increase the reimbursement rate for the administration of the drug, 17P, which is utilized as a treatment to reduce premature births in pregnant women with a history of pre-term delivery.

• February 13, 2015

  Medicaid Eligibility – Children Supplemental Security Income (SSI)

  Repeals the October 20, 1998 Rule governing the provisions for Medicaid eligibility of children receiving Supplemental Security Income (SSI) since children born August 22, 1996 or prior would have reached age 18 by August 22, 2014 and are no longer eligible under this provision.

• February 13, 2015

  Applied Behavior Analysis-Based Therapy Services (LAC 50:XV.Chapters 1-7)

  Continues the provisions of the October 20, 2014 Emergency Rule which amended the provisions of the February 1, 2014 Emergency Rule to ensure compliance with all of the provisions required by the court order issued in Melanie Chisholm, et al vs. Kathy Kliebert class action litigation.

• February 13, 2015

  Behavioral Health Service Providers – Licensing Standards (LAC 48:I.Chapters 74, LAC 48:I.Chapters 56–57 and LAC 48:III.Chapter 5)

  Adopts provisions to establish licensing standards for behavioral health service providers to comply with the directives of Act 308.