Medicaid State Plan A | La Dept. of Health

Medicaid State Plan

Medicaid State Plan

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Section 1 - Single State Agency Organization

Section 1.1 - Designation and Authority
- Attachment 1.1a - Certification of Single State Agency
Section 1.2 - Organization for Administration
- Attachment 1.2a - State Agency Organization and Functions
- Attachment 1.2b - Organization and Function of Bureau of Health Services Financing
- Attachment 1.2c - Professional Medical and Supporting Staff
- Attachment 1.2d - Description of Staff Making Eligibility Decisions
Section 1.3 - Statewide Operation
Section 1.4 - State Medical Care Advisory Committee
Section 1.5 - Pediatric Immunization Program
Section 1.6 - Tribal Consultation of SPA Process

Section 2 - Coverage and Eligibility

Section 2.1 - Application Determination of Eligibility and Furnishing Medicaid
Section 2.2 - Coverage and Conditions of Eligibility
- Attachment 2.2a - Groups Covered and Agencies Responsible for Eligibility
  - Supplement 1 - Reasonable Classifications of Individuals
Section 2.3 - Residence
Section 2.4 - Blindness
Section 2.5 - Disability
Section 2.6 - Financial Eligibility
- Attachment 2.6A Eligibility Conditions and Requirements
  - Supplement 1 - Eligibility Income Levels
  - Supplement 2 - Eligibility Resource Levels
  - Supplement 5 - Methodologies for Treatment of Income and Resources that Differ from SSI
  - Supplement 5a - Methodologies for Treatment of Resources for Individuals with Income up to a Percentage of FPL
  - Supplement 6 - Standards for Optional State Supplementary Payments
  - Supplement 7 - Categorically Needy who are Covered under Requirements more Restrictive than SSI
  - Supplement 8a - More Liberal Methods of Treating Income under 1902(r)(2) of the Act
  - Supplement 8b - More Liberal Methods of Treating Resources under 1902(r)(2) of the Act
  - Supplement 8c - State Long-Term Care Insurance Partnership
  - Supplement 9 - Transfer of Resources
  - Supplement 9a - Transfer of Assets
  - Supplement 10 - Consideration of Medicaid Qualifying Trusts - Undue Hardship
  - Supplement 12 - Variations from the Basic Personal Needs Allowance
  - Supplement 13 - Section 1924 Provisions
  - Supplement 14 - Income and Resource Requirements for Tuberculosis Infected Individuals
  - Supplement 15 - Treatment of Optional Groups of Qualified Aliens
  - Supplement 16 - Eligibility under Section 1931 of the Act
  - Supplement 17 - Disqualification for Long-Term Care Assistance for Individuals with Substantial Home Equity
  - Supplement 18 – Federal Medical Assistance Percentage (FMAP)
Section 2.7 - Medicaid Furnished Out of State
Section 2.8 - Modified Adjusted Gross Income (MAGI)

Section 2 - MMDL and MACPro System Approvals

Eligibility

Section 3 - Services: General Provisions

Section 3.1 - Amount, Duration and Scope of Services
- Attachment 3.1a - Amount Duration and Scope of Services for Categorically Needy
  - Item 1 - Inpatient Hospital Services
  - Item 2a - Outpatient Hospital Services
  - Item 2b - Rural Health Clinic Services
  - Item 2c - FQHC Services
  - Item 3 - Other Laboratory and X-Ray Services
  - Item 4a - Skilled Nursing and Surgical Services for Individuals 21 or Older
  - Item 4b - EPSDT Services
  - Item 4c - Family Planning
  - Item 5 - Physician Services
  - Item 5b - Medical and Surgical Services Furnished by a Dentist
  - Item 6 - Medical and Remedial Care Furnished by Other Licensed Practitioners
  - Item 7 - Home Health Care Services
  - Item 9 - Clinic Services
  - Item 12a - Prescribed Drugs
  - Item 12b - Dentures
  - Item 12c - Prosthetic Devices
  - Item 13c - Preventive Services
  - Item 13d - Rehabilitative Services
  - Item 14a - Services for Individuals 65 or older in Institutions for Mental Diseases
  - Item 15 - Intermediate Care Facility Services
  - Item 16 - Inpatient Psychiatric Facility Services for Under 21
  - Item 17 - Nurse Midwife Services
  - Item 18 - Hospice Care Services
  - Item 19 - Targeted Case Management Services
  - Item 19b - Special Tuberculosis-Related Services for Tuberculosis Infected Individuals
  - Item 20a - Pregnancy Related and Postpartum Services
  - Item 20b - Extended Services for Pregnant Women
  - Item 23 - Nurse Practitioner Services
  - Item 24a - Medical Transportation Services
  - Item 24d - Skilled Nursing Facility Services for Individuals Under 21
  - Item 26 - Personal Care Services
  - Supplement 1 - Targeted Case Management
  - Supplement 2 - Self-Directed Personal Assistance Services
  - Supplement 3 - PACE
  - Supplement 4 - Medication-Assisted Treatment
- Attachment 3.1b - Amount, Duration and Scope of services Provided to Medically Needy Groups
- Attachment 3.1c - Standards and Methods for Assuring High Quality Care
- Attachment 3.1d - Methods of Providing Transportation
- Attachment 3.1e - Standards for Coverage of Organ Transplants
- Attachment 3.1f - Managed Care
Section 3.2 - Coordination of Medicaid with Medicare and Other Insurance
- Attachment 3.2a - Coordination of Medicare
Section 3.3 - Medicaid for Individuals 65 or Over in Institutions for Mental Disease
Section 3.4 - Special Requirements Applicable to Sterilization Procedures
Section 3.5 - Families Receiving Extended Medicaid Benefits
Section 3.6 - Additional Amounts for Nursing Facility Residents

Section 3 - MMDL System Approvals

Alternative Benefit Plan (ABP)

Continue to State Plan Sections 4 - 7

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