Act 421 Children's Medicaid Option (TEFRA/Katie Beckett)

Federal approval from the Centers for Medicare and Medicaid Services (CMS) is required to implement the program. Louisiana Medicaid is currently working with CMS to seek approval of a State Plan Amendment for the program. LDH anticipates the program will be available in January 2022.

Act 421-CMO of the 2019 Regular Legislative Session tasked the Louisiana Department of Health with starting a program that lets certain children with disabilities receive Medicaid coverage, even if their parents earn too much money to qualify for Medicaid.

Act 421 created what is known as a TEFRA option in Medicaid. TEFRA refers to the Tax Equity and Fiscal Responsibility Act of 1982, which is a United States federal law that can help families with children younger than 19 years old who have a disability receive care in their homes rather than an institution. TEFRA programs are sometimes referred to as the Katie Beckett program or the Katie Beckett waiver in other states. In Louisiana, the program has been named the Act 421 Children’s Medicaid Option (TEFRA/Katie Beckett).


In order to be eligible for the Act 421 option, a child must meet all of the following eligibility criteria:

  • Be a Louisiana resident.
  • Be a United States citizen or qualified non-citizen.
  • Under the age of 19 (not to exceed the age of 18).
  • Has a disability that is recognized under the definition of disability utilized in the Supplemental Security Income program of the Social Security Administration, regardless of whether the child is eligible to receive benefits under that program.
  • Ineligible for Medicaid coverage when the income of the child’s parents is considered.
  • Has or has applied for a Social Security Number.
  • Excluding the assets (resources) of parents, the child does not have total assets (resources) exceeding $2,000 in value.
  • Excluding the income of parents, the child’s income is less than three (3) times the Federal Benefit Rate (FBR), which is referred to as the individual Special Income Limit (SIL).
  • The child meets an institutional level of care provided in a hospital, skilled nursing facility, or intermediate care facility (ICF).
  • Care can be provided safely at home for less than the cost of institutional care.


Frequently Asked Questions

Get Involved

The Louisiana Department of Health wants input from parents and advocates as we continue to work to develop Act 421 Children’s Medicaid Option. Email if you’re interested in joining a stakeholder work group.
Archived Stakeholder Meeting Summaries

Contact Us


Mail:        Louisiana Department of Health

                Medicaid Act 421-CMO

                P.O. Box 91030, Bin 24

                Baton Rouge, LA 70821-9030