Medicaid Managed Care Policies & Procedures

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 this purpose, a policy or procedure, as defined by the statute, shall mean a 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.

The following table contains the LDH and managed care organization policies and procedures that are open for public comment.




Item Number  Policy/Procedure   Date Posted  Comment Period Closed   Status Document Links
2025-UHC-377 Implanted Electrical Stimulator for Spinal Cord 10/31/25 12/15/25 Pending Implanted Electrical Stimulator for Spinal Cord
2025-UHC-788 Mechanical Stretching Devices 10/31/25 12/15/25 Pending Mechanical Stretching Devices
2025-UHC-790 Nerve Graft to restore Erectile Function during Radical Prostatectomy 10/31/25 12/15/25 Pending Nerve Graft to restore Erectile Function during Radical Prostatectomy
2025-UHC-1815 Sacral Nerve Stimulation for Urinary and Fecal Indications 10/31/25 12/15/25 Pending Sacral Nerve Stimulation for Urinary and Fecal Indications
2025-UHC-2294 Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions 10/31/25 12/15/25 Pending Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions
2025-LHCC-430 Covered Benefits and Services 10/24/25 12/8/25 Pending Covered Benefits and Services
2025-HUM-1593 Provider Manual 10/24/25 12/8/25 Pending Provider Manual
2025-LHCC-1875 Ongoing Monitoring of Sanctions & Complaints 10/24/25 12/8/25 Completed Ongoing Monitoring of Sanctions & Complaints
2025-ABH-2253 Utilization Management Timeliness Standards and Decision Notification Amendment 10/24/25 12/8/25 Pending Utilization Management Timeliness Standards and Decision Notification Amendment
2025-UHC-215 Spinal Fusion and Bone Healing Enhancement Products 10/24/25 12/8/25 Pending Spinal Fusion and Bone Healing Enhancement Products
2025-UHC-217 Omnibus Codes 10/24/25 12/8/25 Pending Omnibus Codes
2025-UHC-786 Light and Laser Therapy 10/24/25 12/8/25 Pending Light and Laser Therapy
2025-UHC-1404 Breast Imaging for Screening and Diagnosing Cancer 10/24/25 12/8/25 Pending Breast Imaging for Screening and Diagnosing Cancer
2025-ACLA-1442 ACLA Prior Authorization Service List 10/24/25 12/8/25 Pending ACLA Prior Authorization Service List
2025-LHCC-1918 Diabetes Self-Management Training 10/24/25 12/8/25 Pending Diabetes Self-Management Training
2025-UHC-2757 Inhaled Nitric Oxide Therapy 10/24/25 12/8/25 Pending Inhaled Nitric Oxide Therapy

RELATED INFO

Surgeon General Ralph L. Abraham, M.D.

Secretary Bruce D. Greenstein

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