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• 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.

• September 11, 2019

  Disproportionate Share Hospital Payments - Major Medical Centers LAC 50:V.2503 and 2719

  Adopts provisions to establish a qualification criteria and disproportionate share hospital (DSH) payment methodology for major medical centers located in the southeastern area of Louisiana.

• August 09, 2019

  Inpatient Hospital Services – Reimbursement Methodology – Outlier Pool Rate Increase LAC 50:V.954

  Continues the provisions of the July 1, 2019 Emergency Rule which amended the provisions governing the reimbursement methodology for inpatient hospital services in order to increase outlier pool payments in compliance with House Concurrent Resolution 5 of the 2019 Regular Session of the Louisiana Legislature.

• August 09, 2019

  Ground Ambulance Provider Fees and Enhanced Reimbursements for Qualifying Ground Ambulance Service Providers LAC 48:I.4001 and 50.XXVII.331

  Continues the provisions of the July 1, 2019 Emergency Rule which amended the provisions governing ambulance reimbursement in order to include non-emergency ground ambulance services in the health care service provider fees for ground ambulance service providers and the enhanced reimbursement for emergency ground ambulance transportation services, in compliance with Act 299 of the 2019 Regular Session of the Louisiana Legislature.

• August 09, 2019

  Applied Behavior Analysis-Based Therapy Services LAC 50:XV.703

  Amends the provisions governing applied behavior analysis-based therapy services in order to clarify the requirements relative to the appropriate current procedural terminology (CPT) codes to be utilized for reimbursement for these services.

• July 10, 2019

  Facility Need Review – Hospital Off-Site Emergency Departments LAC 48:I.Chapter 125

  Amends the provisions governing the Facility Need Review (FNR) Program in order to establish a process for licensed hospitals to obtain FNR approval for an emergency department licensed as an off-site campus of a hospital in order to ensure access for patients in need of emergent care services.

• June 11, 2019

  Termination of Radiology Utilization Management Services LAC 50:V.6105 and XIX.4501

  Repeals the provisions in Outpatient Hospital Services and Laboratory and Radiology Services governing Radiology Utilization Management in order to align with current fee-for-service and managed care practices relative to prior authorization of high-end radiology services.

• May 10, 2019

  Home and Community-Based Services Waivers – Provider Requirements LAC 50:XXI.Chapter 9

  Amends the general provisions governing home and community-based services (HCBS) waivers in order to require HCBS providers to verify employee Social Security numbers, and to clarify and ensure that these provisions are appropriately promulgated in the Louisiana Administrative Code.

• April 12, 2019

  Pharmacy Benefits Management Program - State Supplemental Rebate Agreement Program LAC 50:XXIX.Chapter 11

  Amends the provisions governing the State Supplemental Rebate Agreement Program in order to remove the requirement for participation in a specific supplemental rebate agreement.

• April 12, 2019

  Hospital Licensing Standards

  Amends the provisions governing the licensing of hospitals in order to clarify the requirements that licensed hospitals shall: 1) be primarily engaged in providing inpatient care and services to inpatients, and 2) ensure that dietary services provided through a contract with a food delivery service meet the same standards as hospitals that provide in-house dietary services to patients..

• April 12, 2019

  Early and Periodic Screening, Diagnosis and Treatment - Personal Care Services LAC 50:XV.Chapter 73

  Amends the provisions governing personal care services (PCS) in the Early and Periodic Screening, Diagnosis and Treatment Program in order to clarify these provisions and update requirements relative to utilization of an electronic visit verification system, billable units, and delivery of PCS.