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 is intending 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 Serices Financing is responsible for the promulgation of Rules governing the administration of the Medicaid Program and licensing/certification policies.

The intent of the provider services manual is to present useful information and guidance to providers participating in the Louisiana Medicaid Program. The first chapter, "General Information and Administration" contains information applicable to all providers. Each remaining chapter is dedicated to a specific program or service and outlines the policies, procedures, qualifications, services and limitations to that service or program.

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. 

Non-Emergency Medical Transportation and Pharmacy Benefits

The MCO contracts provide specified Medicaid core benefits and services, including non-emergency transportation and pharmacy benefits. LDH is developing request for proposals (RFP) for a single broker for transportation services and a single broker for pharmacy benefits, and is inviting input from the public. The comment period ended Saturday, July 31, 2021.