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Amends the provisions governing managed care for physical and behavioral health in order to further clarify the reimbursement methodology currently in use for federally qualified health centers and rural health clinics.
Continues the provisions of the June 9, 2023 Emergency Rule, which amended the provisions governing the Residential Options Waiver self-direction initiative in order to remove specific requirements for employees of beneficiaries in the self-direction service option and stipulate that these providers must meet the qualifications for furnishing personal care services as set forth in LAC 48:I.Chapter 92.
Continues the provisions of the June 9, 2023 Emergency Rule, which amended the provisions governing the Community Choices Waiver self-direction initiative in order to remove the specific age requirement for employees under the self-direction service option and stipulate that these providers must meet the minimum age requirement per LAC 48:I.Chapter 92.
Continues the provisions of the June 9, 2023 Emergency Rule which amended the provisions governing facility need review approvals of licensed and Medicaid certified facility beds in order to prevent the expiration of approvals for nursing facilities, intermediate care facilities for persons with developmental disabilities, and adult residential care providers with inactivated licenses as a result of an executive order or proclamation of emergency or disaster issued in accordance with R.S. 29:724 or 29:766.
Amends the provisions governing Health Services for American Indians in order to align the on-site requirements for physicians in tribally operated 638 facilities with the regulations at 42 CFR 440.90 and §1905(a)(9) of the Social Security Act.
Continues the provisions of the July 1, 2023 Emergency Rule which amended the provisions governing managed care for physical and behavioral health in order to align the medical loss ratio period for the dental benefit plan manager and the Healthy Louisiana managed care organizations with the capitation rating period for the purposes of required reporting, in compliance with 42 CFR 438.74.
Continues the provisions of the May 12, 2023 Emergency Rule which adopted provisions in the Professional Services Program to continue to provide reimbursement for physician directed treatment-in-place ambulance services after the Coronavirus Disease 2019 (COVID-19) public health emergency ended on May 11, 2023.
Continues the provisions of the July 1, 2023 Emergency Rule which amended the provisions governing reimbursement in the Medical Transportation Program in order to align the reimbursement rates established for emergency ambulance services and providers with current practice for Medicaid managed care and fee-for-service in compliance with the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services requirement to transition from the Full Medicaid Pricing program to an approved federal supplemental payment program.
Continues the provisions of the May 15, 2023 Emergency Rule which amends the provisions governing directed payments in order to reserve the right to discontinue interim directed payments to any hospital whose projected recoupment is greater than 50 percent or who discontinues operations during or prior to the directed payment contract period.
Adopts provisions governing medically necessary inpatient services furnished to Louisiana Medicaid beneficiaries by out-of-state hospitals in order to align the reimbursement rates for those services with current in-state inpatient per diem rates for like hospitals/services.
Adopts provisions establishing the standards for participation for fiscal employer agents that provide financial management services for self-directed home and community-based waiver services administered by the Office of Aging and Adult Services and the Office for Citizens with Developmental Disabilities.
Continues the provisions of the July 1, 2023 Emergency Rule which amended the provisions governing provider fees for emergency ground ambulance services in order to ensure that the language in the administrative rule reflects the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services requirement that reimbursement for these services transition from the Full Medicaid Pricing program to an approved federal supplemental payment program.