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Amends the provisions governing the reimbursement methodology for nursing facilities in order to align the case-mix index threshold percentage for nursing facility rate setting with the national threshold percentage.
Continues the provisions of the November 20, 2018 Emergency Rule which adopted provisions governing virtual visitation to provide for consent, by a nursing facility resident or a legal representative, relative to the authorization for installation and use of a monitoring device in the room of the resident in compliance with Act 596 of the 2018 Regular Session of the Louisiana Legislature.
Adopts provisions which: 1) require managed care organizations (MCOs) participating in the Medical Assistance Program to ensure that providers contracted or enrolled with the MCO comply with all Medicaid provider enrollment, credentialing and accreditation requirements; and 2) establish a process and timeline for affected providers to request departmental review of MCO-identified credentialing deficiencies.
Continues the provisions of the October 11, 2018 Emergency Rule which amended the provisions governing intermediate care facilities for individuals with intellectual disabilities in order to extend the period of transitional rates for a large facility that provides continuous nursing coverage to medically fragile populations for two additional years, and aligned the Rule language with the Medicaid State Plan amendment approved by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Adopts provisions governing the Healthy Louisiana Opioid Use Disorder/Substance Use Disorder Waiver, a five-year 1115(a) demonstration waiver approved by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services to permit managed care organizations (MCOs) to provide opioid use disorder/substance use disorder services to Medicaid recipients in an institution for mental disease (IMD) without regard to the monthly MCO length of stay limit for these residential treatment services in an IMD setting.
Amends the provisions governing substance use disorders services in order to align these provisions with the 1115(a) Healthy Louisiana Opioid Use Disorder/Substance Use Disorder Waiver approved by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services..
Adopts provisions governing the Nurse Licensure Compact in order to decrease redundancies in the consideration and issuance of nursing licenses, and to provide an opportunity for interstate practice by nurses who meet the Louisiana Department of Health’s uniform licensure requirements, in compliance with the requirements of Act 577 of the 2018 Regular Session of the Louisiana Legislature.
Amends the provisions governing Medicaid eligibility to allow for the option to eliminate the five-year waiting period for Medicaid coverage of lawfully residing children in compliance with the Children’s Health Insurance Program Reauthorization Act of 2009. The proposed rule also repromulgates the provisions of the June 20, 1998 Rule governing Medicaid eligibility for qualified non-citizens to ensure that these provisions are promulgated in the Louisiana Administrative Code in a clear and concise manner.
Continues the provisions of the October 20, 2018 Emergency Rule which amended the provisions governing the New Opportunities Waiver in order to provide additional reimbursement for services rendered to participants with complex medical and behavioral needs, and to align the minimum age requirement for participation with the waiver amendment approved by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Amends the provisions governing the reimbursement methodology for rural health clinics in order to implement a payment methodology to allow reimbursement for mammography screening and diagnosis services outside of the prospective payment system rate.
Amends the provisions governing the reimbursement methodology for outpatient hospital services in order to increase the reimbursement rates paid to non-rural, non-state hospitals and children’s specialty hospitals in compliance with House Concurrent Resolution 6 of the 2018 Regular Session of the Louisiana Legislature.
Amends the provisions governing medical certification for nursing facility admissions in order to align the requirements for continued stay requests with current Office of Aging and Adult Services policies and procedures to ensure that these provisions are promulgated in a clear and concise manner in the Louisiana Administrative Code.