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.

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Item Number	Policy/Procedure	Date Posted	Comment Period Closed	Status	Document Links
2026-LHCC-687	Measurable Progressive Improvement	6/12/2026	7/27/2026	Pending	Measurable Progressive Improvement
2026-ACLA-1185	Individual Placement and Support	6/12/2026	7/27/2026	Pending	Individual Placement and Support
2026-LHCC-1213	Sacroiliac Joint Fusion	6/12/2026	7/27/2026	Pending	Sacroiliac Joint Fusion
2026-LHCC-1430	Record Keeping and Documentation Standards: Physical Medicine	6/12/2026	7/27/2026	Pending	Record Keeping and Documentation Standards: Physical Medicine
2026-LHCC-1588	Member Advisory of Provider Contract Termination or Limitation Policy	6/12/2026	7/27/2026	Pending	Member Advisory of Provider Contract Termination or Limitation Policy
2026-LHCC-1711	Sympathetic Nerve Block	6/12/2026	7/27/2026	Pending	Sympathetic Nerve Block
2026-LHCC-1750	Sacroiliac Joint Injections – NIA	6/12/2026	7/27/2026	Pending	Sacroiliac Joint Injections – NIA
2026-LHCC-1751	Spinal Cord Stimulation – NIA	6/12/2026	7/27/2026	Pending	Spinal Cord Stimulation – NIA
2026-LHCC-1752	Epidural Spine Injections	6/12/2026	7/27/2026	Pending	Epidural Spine Injections
2026-LHCC-1754	Epidural Spine Injection Trial Intrathecal Hybrid	6/12/2026	7/27/2026	Pending	Epidural Spine Injection Trial Intrathecal Hybrid
2026-LHCC-1755	Paravertebral Facet Joint injections or blocks	6/12/2026	7/27/2026	Pending	Paravertebral Facet Joint injections or blocks
2026-LHCC-1756	Facet Joint Denervation	6/12/2026	7/27/2026	Pending	Facet Joint Denervation
2026-LHCC-1878	Cervical Spine Surgery	6/12/2026	7/27/2026	Pending	Cervical Spine Surgery
2026-LHCC-1880	Hip Arthroplasty	6/12/2026	7/27/2026	Pending	Hip Arthroplasty
2026-LHCC-1881	Hip Arthroscopy	6/12/2026	7/27/2026	Pending	Hip Arthroscopy
2026-LHCC-1882	Knee Arthroplasty	6/12/2026	7/27/2026	Pending	Knee Arthroplasty
2026-LHCC-1883	Lumbar Artificial Disc Replacement	6/12/2026	7/27/2026	Pending	Lumbar Artificial Disc Replacement
2026-LHCC-1884	Lumbar Spine Surgery	6/12/2026	7/27/2026	Pending	Lumbar Spine Surgery
2026-LHCC-1885	Knee Arthroscopy	6/12/2026	7/27/2026	Pending	Knee Arthroscopy
2026-LHCC-1887	Shoulder Arthroplasty	6/12/2026	7/27/2026	Pending	Shoulder Arthroplasty
2026-LHCC-1889	Shoulder Arthroscopy	6/12/2026	7/27/2026	Pending	Shoulder Arthroscopy
2026-HBL-2894	Critical Care to Home	6/12/2026	7/27/2026	Pending	Critical Care to Home
2026-HBL-2906	UM AROW CMBM A2025M5320	6/12/2026	7/27/2026	Pending	UM AROW CMBM A2025M5320
2026-LHCC-2908	Active Procedures, Passive Treatment, & Experimental, Unproven, or Investigational Services	6/12/2026	7/27/2026	Pending	Active Procedures, Passive Treatment, & Experimental, Unproven, or Investigational Services
2026-LHCC-2909	Outpatient Habilitative Physical, Occupational, Speech, and Rehabilitative Speech Therapy	6/12/2026	7/27/2026	Pending	Outpatient Habilitative Physical, Occupational, Speech, and Rehabilitative Speech Therapy
2026-LHCC-110	Continued Stay and Discharge Planning	6/4/2026	7/19/2026	Pending	Continued Stay and Discharge Planning
2026-HBL-2892	UM AROW A2026M5644	6/4/2026	7/19/2026	Pending	UM AROW A2026M5644
2026-ABH-2358	AMA 7100.72 CPT Vest High Frequency	5/29/2026	7/13/2026	Pending	AMA XXXX CPT Vest-High Frequency Chest Wall Oscillation Device
2026-ACLA-1223	Hospice Prior Authorization	5/29/2026	7/13/2026	Pending	Hospice Prior Authorization
2026-ACLA-1442	Prior Authorization Service List	5/29/2026	7/13/2026	Pending	ACLA Prior Authorization Service List
2026-ACLA-1859	Nonpharmacologic Treatments for Chronic Vertigo	5/29/2026	7/13/2026	Pending	Nonpharmacologic Treatments for Chronic Vertigo
2026-ACLA-1871	Three Dimensional Imaging Interpretation	5/29/2026	7/13/2026	Pending	Three Dimensional Imaging Interpretation
2026-ACLA-2313	Microwave Thermotherapy Lung Kidney Tumors	5/29/2026	7/13/2026	Pending	Microwave Thermotherapy Lung Kidney Tumors
2026-ACLA-2432	Air Ambulance Transport	5/29/2026	7/13/2026	Pending	Air Ambulance Transport
2026-ACLA-2902	Continuous Positive Airway Pressure	5/29/2026	7/13/2026	Pending	Continuous Positive Airway Pressure
2026-ACLA-2903	Hospital Services Prior Authorization	5/29/2026	7/13/2026	Pending	Hospital Services Prior Authorization
2026-ACLA-2904	Outpatient Therapy Licensed Practitioners	5/29/2026	7/13/2026	Pending	Outpatient Therapy Licensed Practitioners
2026-ACLA-2905	Hysterectomy	5/29/2026	7/13/2026	Pending	Hysterectomy
2026-HBL-2878	Infusion Administration Facility	5/29/2026	7/13/2026	Pending	Infusion Administration Facility
2026-HBL-2879	UM AROW M5341 M5503 CMBM CD	5/29/2026	7/13/2026	Pending	UM AROW M5341 M5503 CMBM CD
2026-HUM-2316	Hospital-Based Care Coordination of Pregnant Members with Substance Use Disorder - In Lieu of Service	5/22/26	7/5/26	Pending	Hospital-Based Care Coordination of Pregnant Members with Substance Use Disorder - In Lieu of Service
2026-ACLA-2221	Provider Quality Monitoring Strategy	5/22/26	7/6/26	Pending	Provider Quality Monitoring Strategy
2026-HUM-1556	Care Management Program Description	5/22/26	7/6/26	Pending	Care Management Production Description
2026-LHCC-1385	Implantable Wireless PAP Monitoring	5/22/26	7/6/26	Pending	Implantable Wireless PAP Monitoring
2026-HBL-1036	Home Health Utilization Management	5/22/26	7/6/26	Pending	Home Health Utilization Management
2026-LHCC-991	Concurrent Review	5/22/26	7/6/26	Pending	Concurrent Review
2026-HBL-330	Case Management	5/22/26	7/6/26	Pending	Case Management
2026-HBL-946	Member Appeals Core Policy	5/14/26	6/28/26	Pending	Member Appeals Core Process Physical Health
2026-LHCC-1111	Thyroid Insulin Test in Ped	5/14/26	6/28/26	Pending	Thyroid Hormones and Insulin Testing in Pediatrics
2026-LHCC-1113	Cardiac Biomarker Testing	5/14/26	6/28/26	Pending	Cardiac Biomarker Testing
2026-LHCC-1115	Vitamin D Testing in Peds	5/14/26	6/28/26	Pending	Vitamin D Testing in Children and Adolescents
2026-LHCC-1168	Allergy Testing & Therapy	5/14/26	6/28/26	Pending	Allergy Testing and Therapy
2026-LHCC-1216	Bariatric Surgery	5/14/26	6/28/26	Pending	Bariatric Surgery
2026-LHCC-1227	Skin and Soft Tissue Substitutes for Chronic Wounds	5/14/26	6/28/26	Pending	Skin and Soft Tissue Substitutes
2026-LHCC-1279	Measure Serum 1.25 Vit D	5/14/26	6/28/26	Pending	Measurement of Serum 1,25 Vitamin D
2026-LHCC-1280	EEG Headache	5/14/26	6/28/26	Pending	EEG in the Evaluation of Headache
2026-LHCC-1356	Lung Transplantation	5/14/26	6/28/26	Pending	Lung Transplantation
2026-LHCC-1386	Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins	5/14/26	6/28/26	Pending	Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins and Other
2026-LHCC-1387	Percutaneous LAAD Stroke Prevention	5/14/26	6/28/26	Pending	Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention
2026-LHCC-1527	Nerve Blocks and Neurolysis for Pain Management	5/14/26	6/28/26	Pending	Nerve Blocks and Neurolysis for Pain Management
2026-LHCC-1701	Outpatient Testing for DOA (Drugs of Use)	5/14/26	6/28/26	Pending	Drugs of Use Presumptive and Definitive Testing
2026-LHCC-1703	Pediatric Kidney Transplant	5/14/26	6/28/26	Pending	Pediatric Kidney Transplant
2026-LHCC-1705	Invasive and Non-Invasive Home Ventilator	5/14/26	6/28/26	Pending	Home Ventilators
2026-LHCC-1706	Wireless Motility Capsule	5/14/26	6/28/26	Pending	Wireless Motility Capsule
2026-LHCC-1747	PCS-EPSDT Policy	5/14/26	6/28/26	Pending	PCS EPSDT Policy
2026-ABH-2351	AMA XXXX Continuous Positive Airway Pressure	5/14/26	6/28/26	Pending	AMA 7100.70 Continuous Positive Airway Pressure
2026-HUM-2608	Outpatient Lactation Support ILOS	5/14/26	6/28/26	Pending	Outpatient Lactation Support Provider
2026-HBL-2886	Maternity Services Comms RP	5/14/26	6/28/26	Pending	Maternity Services Comms
2026-LHCC-2895	Immobilized Lipase Cartridges (RELiZORB)	5/14/26	6/28/26	Pending	Immobilized Lipase Cartridges
2026-HBL-2896	UM AROW M5513 CMBM CD	5/14/26	6/28/26	Pending	UM AROW M5513 CMBM CD
2026-LHCC-2829	Cardiovascular Stress Test	5/11/26	6/25/26	Pending	Cardiovascular Stress Test
2026-LHCC-2830	Aortic Valve Replacement	5/11/26	6/25/26	Pending	Aortic Valve Replacement
2026-LHCC-1167	DME Clinical Policy	5/11/26	6/25/26	Pending	DME Clinical Policy
2026-LHCC-1217	Ultrasound in Pregnancy	5/11/26	6/25/26	Pending	Ultrasound in Pregnancy
2026-LHCC-1278	Evoked Potential Testing	5/11/26	6/25/26	Pending	Evoked Potential Testing
2026-LHCC-1360	Heart-Lung Transplant	5/11/26	6/25/26	Pending	Heart-Lung Transplant
2026-LHCC-1745	Donor Lymphocyte Infusion	5/11/26	6/25/26	Pending	Donor Lymphocyte Infusion
2026-LHCC-1838	Intensity-Modulated Radiotherapy	5/11/26	6/25/26	Pending	Intensity-Modulated Radiotherapy
2026-LHCC-2232	Concert Genetics General Approach to Genetic Testing	5/11/26	6/25/26	Pending	Concert Genetics General Approach to Genetic Testing
2026-LHCC-2234	Concert Genetics Lung Disorders	5/11/26	6/25/26	Pending	Concert Genetics Lung Disorders
2026-LHCC-2352	ID Multisystem Lab Testing	5/11/26	6/25/26	Pending	ID Multisystem Lab Testing
2026-LHCC-2355	ID Vector Borne and Tropical Disease Lab Testing	5/11/26	6/25/26	Pending	ID Vector Borne and Tropical Disease Lab Testing
2026-LHCC-2357	ID Genitourinary Lab Testing	5/11/26	6/25/26	Pending	ID Genitourinary Lab Testing
2026-HBL-2815	UM AROW CMBM A2026M5387	5/11/26	6/25/26	Pending	UM AROW CMBM A2026M5387
2026-HBL-2876	UM AROW CMBM	5/11/26	6/25/26	Pending	UM AROW CMBM
2026-LHCC-2887	Concert Genetic Testing Identity and Forensics	5/11/26	6/25/26	Pending	Concert Genetic Testing Identity and Forensics
2026-LHCC-2888	Concert Genetic Testing Nutrition and Metabolism	5/11/26	6/25/26	Pending	Concert Genetic Testing Nutrition and Metabolism
2026-LHCC-2889	Concert Genetic Testing Transplant	5/11/26	6/25/26	Pending	Concert Genetic Testing Transplant
2026-LHCC-2890	Concert Genetic Testing Endocrinology	5/11/26	6/25/26	Pending	Concert Genetic Testing Endocrinology
2026-LHCC-502	Clinical Information and Documentation Policy	5/7/26	6/21/26	Pending	Clinical Information and Documentation Policy
2026-LHCC-1508	Intravenous Hydration	5/7/26	6/21/26	Pending	Intravenous Hydration
2026-HUM-1922	UM Home Health Clinical Coverage Policy	5/7/26	6/21/26	Pending	UM Home Health Clinical Coverage Policy
2026-HUM-2528	Applied Behavioral Analysis	5/7/26	6/21/26	Pending	Applied Behavioral Analysis
2026-LHCC-2717	Use of Out-of-Network Providers and Steerage	5/7/26	6/21/26	Pending	Use of Out-of-Network Providers and Steerage
2026-HUM-2811	Mental Health Intensive Outpatient Services In Lieu of Service	5/7/26	6/21/26	Pending	Mental Health Intensive Outpatient Services In Lieu of  Service
2026-LHCC-2880	Ultrasound-Guided Vascular Access	5/7/26	6/21/26	Pending	Ultrasound-Guided Vascular Access
2026-LHCC-2881	Vascular Embolization or Occlusion	5/7/26	6/21/26	Pending	Vascular Embolization or Occlusion
2026-LHCC-2882	Venogram Invasive Vein Mapping	5/7/26	6/21/26	Pending	Venogram Invasive Vein Mapping
2026-LHCC-2883	Venous Duplex	5/7/26	6/21/26	Pending	Venous Duplex
2026-LHCC-2884	Mechanical Circulatory Support - Percutaneous and Permanent	5/7/26	6/21/26	Pending	Mechanical Circulatory Support - Percutaneous and  Permanent
2026-LHCC-2885	Wireless Pulmonary Artery Pressure Device Placement and Monitoring	5/7/26	6/21/26	Pending	Wireless Pulmonary Artery Pressure Device Placement  and Monitoring