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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 August 20, 2015 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.
Continues the provisions of the September 20, 2014 Emergency Rule which amended the provisions of the May 24, 2014 Emergency Rule which established payments to Louisiana Low-Income Academic Hospitals.
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.
Continues the provisions of the September 1, 2014 Emergency Rule which amended the provisions governing reimbursement for emergency medical aircraft transportation in order to increase the rates for services originating in rural areas.
Amends the provisions of the October 1, 2014 Emergency Rule governing the reimbursement methodology for non-emergency medical transportation in order to clarify these provisions, and to bring the language of this Rule into compliance with the approved State Plan.
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.
Continues the provisions of the September 20, 2014 Emergency Rule which amended the provisions governing therapeutic group homes to increase the number of beds allowed and to revise provider responsibilities.
The August 2015 Legislative Oversight Committee reports have been submitted to the respective legislative oversight committees in accordance with R.S. 49:968(D)(1)(b)(c)
Amends the provisions governing the reimbursement methodology for non-state intermediate care facilities for persons with intellectual disabilities to establish supplemental Medicaid payments.
Amends the provisions governing the Medically Needy Program in order to further clarify the provisions of the January 20, 2015 Emergency Rule which repromulgated and revised these provisions in a codified format for inclusion in the Louisiana Administrative Code.
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.