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LDH News

• 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.

• November 13, 2023

  Home and Community-Based Services Waiver – Adult Day Health Care Waiver: LAC 50:XXI.2101,2103,2301,2703,2901, and 2903

  Continues the provisions of the November 09, 2023 Emergency Rule which extended the expiration date for health status monitoring, home delivered meals, activity and sensor monitoring, and personal emergency response systems that were initially added to the Adult Day Health Care waiver as temporary services during the Coronavirus Disease 2019 (COVID-19) public health emergency (PHE) and were extended beyond the May 11, 2023 PHE end date as allowed by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.

• November 13, 2023

  Disproportionate Share Hospital Payments – Northern Area Psychiatric Hospital: LAC 50:V.2503 and 2721

  Amends the provisions governing disproportionate share hospital payments to establish the qualification criteria and methodology for payments for the uncompensated care costs of inpatient psychiatric hospitals located in the northern area of the state with an academic training mission for services provided to uninsured and low-income individuals from the payment pool created in accordance with Act 447 of the 2023 Regular Session of the Louisiana Legislature.

• October 13, 2023

  Nursing Facilities - Optional State Assessment LAC 50:II.10123 and 20001

  Continues the provisions of the October 1, 2023 Emergency Rule, which amended the provisions governing the standards for payment and reimbursement for nursing facilities in order to implement the required transition from the current resource utilization group (RUG-III/RUG-IV) case-mix classification model used under the Medicare skilled nursing facility prospective payment system to the patient driven payment model which was delayed by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services until October 1, 2023 due to the COVID-19 public health emergency and to mandate use of the optional state assessment.