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LDH News

• August 11, 2015

  Therapeutic Group Homes - Behavioral Health Integration LAC 50:XXXIII.Chapters 121-127

  Amends the provisions governing TGHs in order to: 1) narrow the statewide management organization’s scope of service administration to 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) delegate provider certification functions to managed care organizations; 4) update the provisions governing covered services; and 5) revise the reimbursement methodology to update these provisions to be consistent with current program operations.

• July 10, 2015

  Case Management - Licensing Standards (LAC 48:I.4929)

  Continues the provisions of the July 1, 2015 Emergency Rule which amended the licensing standards governing providers of case management services to exempt OAAS support coordination service providers and DCFS foster care and family support workers from these licensing standards since OAAS and DCFS will provide certification for support coordination/case management services rendered by their workers.

• July 10, 2015

  Emergency Medical Transportation Services – Ambulance Licensing Standards (LAC 48:I.6001, 6037, 6057)

  Amends the provisions governing the licensing standards for ambulance service providers to establish protocols relative to the assessment and transport of patients with cardiac and stroke emergencies.

• July 10, 2015

  Home and Community-Based Services Waivers – Residential Options Waiver (LAC 50:XXI.Chapters 161-169)

  Continues the provisions of the May 20, 2011 Emergency Rule which amended the provisions of the August 20, 2010 Emergency Rule governing the allocation of waiver opportunities in order to adopt criteria for crisis diversion, to revise the provisions governing the individuals who may be offered a waiver opportunity, and to clarify the provisions governing the Developmental Disabilities Request for Services Registry.

• July 10, 2015

  Home and Community-Based Services Waivers – Residential Options Waiver - Permanent Supportive Housing Services (LAC 50:XXI.16339,16341 and 16901)

  Amends the Rule governing the Residential Options Waiver in order to adopt provisions for the coverage of housing stabilization transition and housing stabilization services.

• July 10, 2015

  Nursing Facilities - Licensing Standards (LAC 48:I.9704, 9707, and Chapter 99)

  Continues the provisions of the May 20, 2014 Emergency Rule which amended the licensing standards governing nursing facilities in order to clarify the provisions for Alzheimer’s special care disclosure, and to revise the provisions governing approval of plans and physical environment.

• July 10, 2015

  School Based Behavioral Health Services (LAC 50:XXXIII.Chapters 41-47)

  Amends the provisions governing school based health services in order to transition these services out of managed care and into the group of school based Medicaid services provided by Local Education Agencies.

• June 11, 2015

  Targeted Case Management - Foster Care and Family Support Worker Services (LAC 50:XV.Chapter 115)

  Continues the provisions of the July 1, 2015 Emergency Rule which amended the provisions governing TCM services in order to adopt provisions for reimbursing the Department of Children and Family Services for services rendered to Medicaid eligible children by foster care and family support workers.

• June 10, 2015

  Managed Care for Physical and Basic Behavioral Health - Timely Filing of Claims (LAC 50:I.3511)

  Amends the provisions governing managed care for physical and basic behavioral health in order to revise the timely filing requirements for provider claims.

• May 12, 2015

  Medicaid Eligibility - Federally Facilitated Marketplace Assessments (LAC 50:III.505)

  Adopts provisions to become an assessment state for Medicaid eligibility determinations by only accepting eligibility assessments from the Federally Facilitated Marketplace (FFM) rather than accepting Medicaid eligibility determinations made by the FFM.

• May 12, 2015

  Targeted Case Management - Reimbursement Methodology (LAC 50:XV.10701)

  Continues the provisions of the July 1, 2014 Emergency Rule which amended the provisions governing the reimbursement methodology for Targeted Case Management (TCM) services provided to New Opportunities Waiver (NOW) recipients in order to adopt a payment methodology based on a flat monthly rate rather than 15-minute increments.

• April 10, 2015

  Behavioral Health Services – Statewide Management Organization – LaCHIP Affordable Plan Benefits Administration (LAC 50:XXXIII.103)

  Continues the provisions of the January 1, 2013 and August 1, 2014 Emergency Rules which amended the provisions governing the statewide management organization that is responsible for behavioral health services in order to include the administration of behavioral health services covered under the LaCHIP Affordable Plan (Phase 5).