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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.