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Amends the provisions governing the reimbursement methodology for nursing facilities in order to establish supplemental Medicaid payments for qualifying nursing facilities, owned or operated by a non-state governmental organization (NSGO), that have entered into an agreement with the department to participate.
Continues the provisions of the October 1, 2015 emergency rule which amended the provisions governing disproportionate share hospital (DSH) payments to reduce DSH payments to qualifying hospitals for inpatient psychiatric services.
Continues the provisions of the September 20, 2015 emergency rule which amended the provisions governing the Facility Need Review (FNR) program in order to provide a process for supplementing an FNR application that has been denied prior to appeal, provide time frames within which home and community-based service providers must become licensed after they have been approved through the FNR process and amend the provisions governing the FNR process for nursing facilities relative the statutory moratorium.
Amends the provisions governing federally qualified health center service limits in order to remove the 12 visits per year limit for Medicaid recipients 21 years of age and older.
Continues the provisions of the November 20, 2014 emergency rule which amended the provisions governing the licensing standards for home and community-based services providers to clarify these provisions and to include licensing provisions for monitored in-home caregiving services.
Continues the provisions of the November 20, 2014 Emergency Rule which amended the provisions governing the Community Choices Waiver in order to clarify the provisions governing monitored in-home caregiving services and to revise the provisions governing the organized health care delivery system.
Amends the provisions governing outpatient hospital services in order to remove the 12 visits per year limit on physician services provided in a clinic in an outpatient hospital setting.
Amends the provisions governing the licensing of pain management clinics to provide for the expiration of licensure exemptions and related matters in compliance with Act 714 of the 2014 Regular Session of the Louisiana Legislature, and to revise these provisions to ensure that they are consistent with licensing standards for other health care providers and current enforcement processes.
Repeals the September 20, 1975 Rule governing physician visits, adopts provisions in the Professional Services Program governing physician services in order to remove the limits from outpatient physician visits, and ensures that these provisions are promulgated in a codified format for inclusion in the Louisiana Administrative Code.
Amends the provisions governing rural health clinic services in order to remove the 12 visits per year limit for Medicaid recipients 21 years of age and older.
Amends the provisions governing adult behavioral health services in order to: 1) reflect the integration of specialized behavioral health services into the Managed Care for Physical and Basic Behavioral Health model; 2) update the service criteria for culturally competent care; 3) change the recipient qualifications; 4) revise the assessment criteria; 5) remove service limitations for psychosocial rehabilitation and crisis intervention services; and 6) revise the reimbursement methodology to reflect capitation payments to managed care organizations rather than a statewide management organization.
Amends the provisions governing behavioral health services coordinated by the statewide management organization (SMO) to: 1) narrow the SMO’s scope of service administration to coordinated system of care (CSoC) services only; 2) reflect the integration of specialized behavioral health services (with the exception of CSoC services) into the Managed Care for Physical and Basic Behavioral Health model; 3) revise the enrollment provisions; and 4) revise the reimbursement methodology to reflect capitation payments to managed care organizations rather than a statewide management organization.