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Medicaid Notices & Public Comments
Louisiana Medicaid (Title XIX) State Plan and Amendments
The officially recognized document describing the nature and scope of the State of Louisiana Medicaid Program. There are seven separate sections that comprise the State Plan as well as many accompanying attachments and Amendments that are added each year. Each part was developed by Louisiana and approved by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS).
Louisiana Medicaid Administrative Rulemaking Activity
Pursuant to R.S. 49:950, et seq., the Louisiana Administrative Procedure Act, the Louisiana Department of Health, Bureau of Health Services Financing gives public notice that the agency intends to take a particular action, adopt policy, or establish regulations through the administrative rulemaking process. The Medicaid Policy and Compliance Section of the Bureau of Health Services Financing is responsible for the promulgation of Rules governing the administration of the Medicaid Program and licensing/certification policies.
Medicaid Provider Services Manual
In accordance with La. R.S. 46:460.51, et seq., prior to adopting, approving, amending, or implementing certain policies or procedures, LDH will publish the proposed policy or procedure for the purpose of soliciting public comments for a period of 45 days, unless the change(s) are deemed of imminent peril to the public health, safety, or welfare and requires immediate approval. Changes to the provider services manual are listed and open for public comment. To provide feedback on these changes, please complete this form. Refer to the links below the list of manual changes for archived postings and public comments.
Contract Amendments
The Louisiana Department of Health is contracted with several managed care entities (MCE) to provide health care services to individuals enrolled in the Medicaid managed care program. The MCEs include managed care organizations (MCO), a dental benefits manager, and a Prepaid Inpatient Health Plan for the Coordinated System of Care.
Managed Care Policies & Procedures
Managed care policies and procedures include any requirement governing the administration of managed care organizations specific to billing guidelines, medical management and utilization review guidelines, case management guidelines, claims processing guidelines and edits, grievance and appeals procedures and process, other guidelines or manuals containing pertinent information related to operations and pre- processing claims, and core benefits and services.
Demonstrations and Waivers
The Louisiana Department of Health administers several demonstration and waiver programs under Sections 1115, 1915(b), and 1915(c) federal authorities. Prior to submitting new or amended applications to CMS for approval, these documents will be posted for public review and comment. Any comments received during the public comment period will be addressed in the application or amendment prior to submission to CMS.