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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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Inpatient Hospital Services - Public-Private Partnerships - Reimbursement Methodology (LAC 50:V.1703)
Continues the provisions of the July 20, 2013 Emergency Rule which amended the provisions of the April 15, 2013 Emergency Rule in order to revise the formatting of these provisions as a result of the promulgation of the June 1, 2013 Emergency Rule to assure that these provisions are promulgated in a clear and concise manner in the Louisiana Administrative Code.
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Inpatient Hospital Services - Public Private Partnerships - Supplemental Payments (LAC 50:V.Chapter 17)
Continues the provisions of the November 1, 2012 Emergency Rule which amended the provisions governing inpatient hospital services to establish supplemental Medicaid payments to non-state owned hospitals in order to encourage them to take over the operation and management of state-owned and operated hospitals that have terminated or reduced services.
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Nursing Facilities - Reimbursement Methodology (LAC 50:II.20001)
Continues the provisions of the July 11, 2015 Emergency Rule which amended the provisions governing the reimbursement methodology for nursing facilities in order to suspend the provisions of LAC 50:II.Chapter 200, and to impose provisions to ensure that the rates in effect do not increase for the SFY 2016 rating period.
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Disproportionate Share Hospital Payments - Mental Health Emergency Room Extensions (LAC 50:V.2711)
Continues the provisions of the March 5, 2015 Emergency Rule which repealed the provisions governing disproportionate share hospital (DSH) payments for Mental Health Emergency Room Extensions in order to eliminate these DSH payments.
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Early and Periodic Screening, Diagnosis and Treatment - School-Based Nursing Services (LAC 50:XV.9501)
Continues the provisions of the July 1, 2015 Emergency Rule which amended the provisions governing school-based nursing services covered in the EPSDT Program to remove the IEP requirement.
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Inpatient Hospital Services – Non-Rural, Non-State Hospitals - Reinstatement of Additional Payments for Hemophilia Blood Products (LAC 50:V.965)
Continues the provisions of the July 1, 2015 Emergency Rule which amended the provisions governing the reimbursement methodology for inpatient hospital services rendered by non-rural, non-state hospitals to reinstate reimbursements for costs incurred in the purchase of blood products for certain Medicaid recipients diagnosed with, and receiving inpatient treatment for, hemophilia.
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Medicaid Expansion under the Affordable Care Act LAC 50:I.Chapter 101- 103
Adopts provisions in the Medicaid Program to: 1) expand Medicaid coverage to individuals from age 19 to 65 years old at or below 133 percent of the Federal Poverty Level with a 5 percent income disregard as provided in 42 CFR 435.119; 2) implement a Secretary-approved coverage option which incorporates the benefits and services covered under the Medicaid State Plan, including the essential health benefits as provided in §1302(b) of ACA; 3) use the Basic Blue Cross/Blue Shield Preferred Provider Option offered through the Federal Employees Health Benefit program as the state’s benchmark benefit package; and 4) establish provisions for the use of the Supplemental Nutrition Assistance Program (SNAP) option for streamlined enrollment of SNAP recipients who meet eligibility requirements for the new adult group.
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Managed Care for Physical and Behavioral Health - Expansion under the Affordable Care Act LAC 50:I.3103,3301,3507,3509
Amends the provisions governing managed care for physical and behavioral health to enroll the new adult group into the Bayou Health Program.
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Medicaid Eligibility - Expansion under the Affordable Care Act LAC 50:III.2317
Amends the provisions governing Medicaid eligibility to adopt provisions in the Medicaid program to expand coverage to the new adult group under the provisions of the Affordable Care Act.
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Greater New Orleans Community Health Connection - Waiver Termination LAC 50 :XXII.Chapters 61-69
Repeals the provisions governing the Greater New Orleans Community Health Connection (GNOCHC) Waiver in order to terminate this optional Medicaid program. The terms and conditions of the GNOCHC Waiver require termination of the waiver concurrent with the implementation of Medicaid coverage for the new adult group provided by the Affordable Care Act.
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February 2016 Final Rules
The Department of Health and Hospitals, Bureau of Health Services Financing has submitted Final Rules to the Office of the State Register for publication in the February 20, 2016 edition of the Louisiana Register in accordance with the provisions of the Administrative Procedure Act, R.S. 49:950 et seq. Prior submissions are available in the archives.