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LDH News
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October 2023 Final Rules
The Louisiana Department of Health, Bureau of Health Services Financing has submitted Final Rules to the Office of the State Register for publication in the October 20, 2023 edition of the Louisiana Register in accordance with the provisions of the Administrative Procedure Act, R.S. 49:950 et seq.
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Medical Transportation Program - Non-Emergency Medical Transportation - American Rescue Plan Act LAC 50:XXVII.531
Amends the provisions in the Medical Transportation Program governing American Rescue Plan Act (ARPA) bonus payments to providers of non-emergency medical transportation (NEMT) services in order to establish the guidelines the department will utilize to oversee the administration and distribution of ARPA bonus payment funds to eligible NEMT providers by the Medicaid managed care organizations.
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Targeted Case Management and Home and Community-Based Services Waivers
Continues the provisions of the May 12, 2023 Emergency Rule, which amended LAC 50:XV.Subpart 7 and LAC 50:XXI.Subparts 5, 9, 11 and 13 in order to temporarily extend, as permitted by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, the allowances made for early and periodic screening, diagnosis and treatment services and the relaxation of certain home and community-based services waivers provisions throughout the Coronavirus Disease 2019 (COVID-19) public health emergency.
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Nursing Facilities - Optional State Assessment LAC 50:II.10123 and 20001
Continues the provisions of the October 1, 2023 Emergency Rule, which amended the provisions governing the standards for payment and reimbursement for nursing facilities in order to implement the required transition from the current resource utilization group (RUG-III/RUG-IV) case-mix classification model used under the Medicare skilled nursing facility prospective payment system to the patient driven payment model which was delayed by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services until October 1, 2023 due to the COVID-19 public health emergency and to mandate use of the optional state assessment.
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Medical Transportation Program - Non-Emergency Medical Transportation - American Rescue Plan Act LAC 50:XXVII.531
Continues the provisions of the December 1, 2023 Emergency Rule, which amended the provisions in the Medical Transportation Program governing American Rescue Plan Act (ARPA) bonus payments to providers of non-emergency medical transportation (NEMT) services in order to establish the guidelines the department will utilize to oversee the administration and distribution of ARPA bonus payment funds to eligible NEMT providers by the Medicaid managed care organizations.
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Medical Transportation Program - Emergency Medical Transportation LAC 50:XXVII.Chapter 3
Continues the provisions of the September 11, 2023 Emergency Rule, which amended the July 1, 2023 Emergency Rule promulgated to comply with the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services requirement that reimbursement for emergency ambulance services transition from the Full Medicaid Pricing program to an approved federal supplemental payment program.
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Medicaid Eligibility - Incurred Medical and Remedial Care Expenses LAC 50:III.941
Adopts provisions governing incurred medical and remedial care expenses in the determination of financial eligibility for the Medical Assistance Program in order to deduct expenses incurred for necessary medical and remedial care, subject to the reasonable limits, from the individual’s income when calculating patient liability to an institution and to limit the time institutions have to report these expenses, in compliance with 42 C.F.R. Part 435 Subparts H and I.
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Home Health Program - American Rescue Plan Act LAC 50:XIII.801
Amends the provisions governing nursing recruitment and retention payments in the Home Health Program as a result of the decision by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services to continue to provide funding under the American Rescue Plan Act of 2021 through March 2025.
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Home and Community-Based Services Waivers - Supports Waiver LAC 50:XXI.Chapters 53-61
Amends the provisions governing the Supports Waiver to: 1) add specialized medical equipment and supplies (incontinence supplies) and community life engagement development as services, and transportation as a separate service; 2) add reimbursement for each new service; and 3) allow prevocational services to be delivered virtually in order to align the administrative Rule with the waiver application approved by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.
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Home and Community-Based Behavioral Health Services Waiver - Coordinated System of Care Discharge Criteria LAC 50:XXXIII.8103
Amends the provisions governing the home and community-based behavioral health services waiver in order to clarify the criteria for discharge from the Coordinated System of Care program and ensure that members are aware that their failure to cooperate in the re-evaluation assessment will result in discharge from the waiver program.
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October 2023 Legislative Oversight Committee Activity
The October 2023 Legislative Oversight Committee reports have been submitted to the respective legislative oversight committees in accordance with R.S. 49:968(D)(1)(b)(c)