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Recovery Audit Contractor Program LAC 50:I.Chapter 85
Continues the provisions of the November 20, 2014 Emergency Rule which adopted provisions to establish the Recovery Audit Contractor program.
LDH News
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Professional Services Program - Reimbursement Methodology - Supplemental Payments LAC 50:IX.15151 and 15153
Continues the provisions of the February 20, 2017 Emergency Rule which amended the provisions governing the Professional Services Program to revise the reimbursement methodology for supplemental payments to physicians and other professional service practitioners in order to clarify the qualifying criteria for these payments and to reformat the provisions to ensure they are promulgated in a clear and concise manner in the Louisiana Administrative Code.
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Inpatient Hospital Services - High Medicaid Hospitals - Supplemental Payments Pool Reduction LAC 50:V.953
Continues the provisions of the March 1, 2017 Emergency Rule which amended the provisions governing inpatient hospital services to reduce the total supplemental payments pool for non-rural, non-state hospitals classified as high Medicaid hospitals.
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Disproportionate Share Hospital Payments – Major Medical Centers LAC 50:V.2715
Continues the provisions of the February 20, 2017 Emergency Rule which amended the provisions of the June 30, 2016 Emergency Rule governing disproportionate share hospital (DSH) payments to major medical centers located in the central and northern areas of Louisiana in compliance with U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) requirements.
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Pharmacy Benefits Management Program - Methods of Payment
Continues the provisions of the October 1, 2014 Emergency Rule which rescinded the provisions of the November 1, 2012 Emergency Rule governing the reimbursement methodology for services rendered in the Pharmacy Benefits Management Program, and returned to the reimbursement rates in effect on September 5, 2012 which is consistent with the currently approved Medicaid State Plan.
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Outpatient Hospital Services - Non-Rural, Non-State Hospitals - Supplemental Payments for Monroe Area Hospitals LAC 50:V.6903
Continues the provisions of the February 12, 2015 Emergency Rule which amended the provisions governing the reimbursement methodology for outpatient hospital services rendered by non-rural, non-state hospitals in order to adopt a supplemental payment methodology for services provided by hospitals located in LDH Administrative Region 8 in the Monroe area.
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Outpatient Hospital Services - Non-Rural, Non-State Hospitals - Supplemental Payments for Baton Rouge Area Hospitals LAC 50:V.6905
Continues the provisions of the February 12, 2015 Emergency Rule which amended the provisions governing outpatient hospital services rendered by non-rural, non-state hospitals in order to adopt a supplemental payment methodology for services provided by hospitals located in the Baton Rouge area.
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Outpatient Hospital Services - Children’s Specialty Hospitals - Supplemental Payments for New Orleans Area Hospitals LAC:V.6121
Continues the provisions of the February 12, 2015 Emergency Rule which adopted a supplemental payment methodology for outpatient hospital services rendered by children’s specialty hospitals in the New Orleans area.
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Intermediate Care Facilities for Persons with Intellectual Disabilities - Public Facilities - Reimbursement Rate Increase LAC 50:VII.32969
Continues the provisions of the October 1, 2014 Emergency Rule which amended the provisions governing the transitional rates for public facilities in order to increase the Medicaid reimbursement rate.
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Inpatient Hospital Services - Non-Rural, Non-State Hospitals - Supplemental Payments for Monroe Area Hospitals LAC 50:V.971
Continues the provisions of the February 12, 2015 Emergency Rule which amended the provisions governing the reimbursement methodology for inpatient hospital services rendered by non-rural, non-state hospitals in order to adopt a supplemental payment methodology for services provided by hospitals located in LDH administrative region 8 in the Monroe area.
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Inpatient Hospital Services - Non-Rural, Non-State Hospitals - Supplemental Payments for Baton Rouge Area Hospitals LAC 50:V.973
Continues the provisions of the February 12, 2015 Emergency Rule which amended the provisions governing inpatient hospital services rendered by non-rural, non-state hospitals in order to adopt a supplemental payment methodology for services provided by hospitals located in the Baton Rouge area.
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Inpatient Hospital Services - Children’s Specialty Hospitals - Supplemental Payments for New Orleans Area Hospitals LAC 50:V.969
Continues the provisions of the February 12, 2015 Emergency Rule which adopted a supplemental payment methodology for inpatient hospital services rendered by children’s specialty hospitals in the New Orleans area.