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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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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Continues the provisions of the March 5, 2015 Emergency Rule which repealed the provisions governing disproportionate share hospital (DSH) payments for Mental Health Emergency Room Extensions in order to eliminate these DSH payments.
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Adult Mental Health Services – Covered Services and Recipient Qualifications (LAC 50:XXXIII.Chapters 61-67)
Amends the provisions governing adult behavioral health services in order to: 1) provide Medicaid coverage and reimbursement for license mental health professional services and mental health rehabilitative services to adult members enrolled in Bayou Health and terminate the behavioral health services rendered under the 1915(i) State Plan authority; 2) establish the recipient qualifications criteria; and 3) revise the assessment and plan of care requirements.
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Facility Need Review – Outpatient Abortion Facilities (LAC 48:I.Chapter 125)
Amends the provisions of the July 1, 2015 Emergency Rule governing the facility need review (FNR) process in order to correct the formatting of §12503 as a result of the promulgation of a January 20, 2015 Rule governing the FNR process. The July 1, 2015 Emergency Rule removed outpatient abortion facilities from the FNR process.
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Home and Community Based Services Waivers – Adult Day Health Care Waiver – Electronic Visit Verification (LAC 50:XXI.2705)
Amends the provisions governing the ADHC Waiver in order to adopt requirements which mandate that providers of personal assistant services must utilize the electronic visit verification (EVV) system designated by the department for automated scheduling, time and attendance tracking, and billing for certain home and community-based services.
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Home and Community-Based Services Waivers – Community Choices Waiver (LAC 50:XXI.8329 and 8601)
Amends the provisions governing the Community Choices Waiver in order to further clarify the provisions of the November 20, 2014 Emergency Rule which amended the provisions governing monitored in-home caregiving services and revised the provisions governing the organized health care delivery system.
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Inpatient Hospital Services – Non-Rural, Non-State Hospitals – Public Hospitals Supplemental Payments (LAC 50:V.963)
Amends the reimbursement methodology governing inpatient hospital services in order to revise the provisions governing supplemental Medicaid payments to qualifying non-rural, non-state public hospitals for East Jefferson.
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Adult Mental Health Services – Covered Services and Recipient Qualifications (LAC 50:XXXIII.Chapters 61-67)
Continues the provisions of the December 1, 2015 Emergency Rule which amended the provisions governing adult mental health services in order to: 1) provide Medicaid coverage and reimbursement for licensed mental health professional services and mental health rehabilitative services to adult members enrolled in Bayou Health and terminate the behavioral health services rendered under the 1915(i) State Plan authority; 2) establish the recipient qualifications criteria; and 3) revise the assessment and plan of care requirements.
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Disproportionate Share Hospital Payments - Louisiana Low-Income Academic Hospitals (LAC 50:V.2903 and Chapter 31)
Continues the provisions of the provisions of the September 20, 2014 Emergency Rule which amended the provisions of the May 24, 2014 Emergency Rule to clarify the provisions governing the payment methodology to Louisiana Low-Income Academic Hospitals.
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Facility Need Review – Outpatient Abortion Facilities (LAC 48:I.Chapter 125)
Continues the provisions of the October 20, 2015 Emergency Rule which amended the provisions of the July 1, 2015 Emergency Rule in order to correct the formatting of §12503 as a result of the promulgation of a January 20, 2015 Rule governing the FNR process.
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Home and Community-Based Services Waivers – Residential Options Waiver – Reserved Capacity Group (LAC 50:XXI.16107, 16343, 16705 and 16901)
Amends the provisions governing the Residential Options Waiver (ROW) to create a reserved capacity group to allow individuals with developmental disabilities who receive services in the Community Choices Waiver or the Adult Day Health Care Waiver programs to transition into the ROW.
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Nursing Facilities - Non-State Governmental Organizations - Supplemental Payments (LAC 50:II.20029)
Amends the provisions governing the reimbursement methodology for nursing facilities in order to establish supplemental Medicaid payments for qualifying nursing facilities, owned or operated by a non-state governmental organization (NSGO), that have entered into an agreement with the department to participate.