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LDH Resources
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Details:
- Medicaid
- Managed Care
Keywords: SCG, Managed Care 3.0, CSoC, DBPM, Transportation Manager, TM
Downloadable Assets:
System Companion Guide Change Control Table Appendix A: Acronyms, Definitions and Data Elements Appendix B: Frequently Asked Questions Appendix C: Code Sets Appendix D: MCE Onboarding and Encounter Testing - How to be an MCE Appendix E: EDI Test Plan and File Exchange Schedule Appendix F: System Generated Files and Reports Appendix G: Helpful Websites Appendix H: 820 File - FI to MCO Appendix I: MCE SCG Links to Other Documents Appendix J: Medicaid MMIS Claims and Encounter Inquiry Procedure Dental Plan Comparison Chart Behavioral Health Provider Types and Specialties Non-EDI File Layout Behavioral Health and SMO Non-EDI File Layout Transportation Non-EDI File Layout EDI Annual Certification of Electronic Files Form Annual EDI Cover Letter Encounter Data Certification Form EDI Transmission Research Request Form - Gainwell MCE Registration To Do List MCE Testing Protocol MCO Registration Packet MES Inquiry Request Form TPL Links to Update Recipient Insurance Edits Comprehensive, Repairable and Non-Repairable MCE Tables Behavioral Health and Dental SMO non-EDI File Layout -
Details:
- Medicaid
- Pharmacy
The PDL applies to all individuals enrolled in Louisiana Medicaid, including those covered by one of the managed care organizations (MCOs) and those in the Fee-for-Service (FFS) program.
Downloadable Assets:
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Details:
- Medicaid
- Pharmacy
Keywords: PDL, Diabetes, Diabetic PDL
Downloadable Assets:
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Details:
- Medicaid
- Pharmacy
Downloadable Assets:
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Details:
- Medicaid
- Managed Care
This report is submitted in response to Act 482 of the 2018 Regular Legislative Session. The report contains requested data on the Medicaid expansion population and managed care organization (MCO) pharmacy benefit managers (PBM). As part of the Medicaid Managed Care Transparency Report, this report includes those expansion population counts and expenditures for individuals enrolled in an MCO for either full or partial benefits.
Downloadable Assets:
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Details:
- Medicaid
This report is submitted pursuant to Act 670 (Senate Bill 298) of the 2022 Regular Louisiana Legislative Session, which requires the Louisiana Department of Health (LDH) to conduct an annual review of all medications and forms of treatment for sickle cell disease (SCD) that are eligible for coverage under the Louisiana Medicaid program.
Downloadable Assets:
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Details:
- Medicaid
- Managed Care
Annual reports from Louisiana's Medicaid program (Bureau of Health Services Financing).
Downloadable Assets:
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Details:
- Medicaid
- Managed Care
RFP #, DBPM 3.0 (1/1/2021 - present) DentaQuest (DQ) and Managed Care of North America (MCNA)
Downloadable Assets:
Request for Proposals DQ Contract DQ Amd 1 DQ Amd 3 DQ Amd 4 DQ Amd 5 DQ Amd 6 DQ Amd 7 DQ Amd 8 DQ Amd 9 DQ Amd 10 DQ Amd 11 MCNA Contract MCNA Amd 1 MCNA Amd 2 MCNA Amd 3 MCNA Amd 4 MCNA Amd 5 MCNA Amd 6 MCNA Amd 7 MCNA Amd 8 MCNA Amd 9 MCNA Amd 10 MCNA Amd 11 DQ Amd 12 DQ Amd 13 DQ Amd 14 MCNA Amd 12 MCNA Amd 13