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Dr. Courtney N. Phillips
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RFP Appendices and Attachments

Appendix A: LDH Standard Contract Form (CF-1)

Appendix B: Model Contract

  • Attachment A: MCO Covered Services
  • Attachment D: Provider Network Standards
  • Attachment E: Table of Monetary Penalties
  • Attachment G: Quality Performance Measures
  • Attachment H: HIPAA Business Associate Addendum

Appendix C: Proposal Compliance Matrix

Appendix D: Certification Statement

Appendix E: Medicaid Ownership and Disclosure Form

Appendix F: Material Subcontractor Response Template

Appendix F: Material Subcontractor Response Template (revised)

Appendix G: Veteran and Hudson Initiatives

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Mailing Address: Louisiana Department of Health | P. O. Box 629 | Baton Rouge, LA 70821-0629
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