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LDH Resources
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Details:
- Legislative & Governmental Relations
- Medicaid
This report is submitted to the Joint Legislative Committee on the Budget. LDH is required to publish quarterly a report containing data directly related to payment for health care services through the implementation of a health coverage expansion of the Louisiana medical assistance program, in addition to directed payments and other supplemental payments made to hospitals. HCR 2 HCR 3
Downloadable Assets:
Quarterly Report – Medicaid Expansion, Directed Payments, and Supplemental Payments Made to Hospitals SFY 2025, Quarter 1 Quarterly Report – Medicaid Expansion, Directed Payments, and Supplemental Payments Made to Hospitals SFY 2024, Quarter 2 Quarterly Report – Medicaid Expansion, Directed Payments, and Supplemental Payments Made to Hospitals SFY 2024, Quarter 1 Quarterly Report – Medicaid Expansion, Directed Payments, and Supplemental Payments Made to Hospitals SFY 2024, Quarter 3 Quarterly Report – Medicaid Expansion, Directed Payments, and Supplemental Payments Made to Hospitals SFY 2024, Quarter 4 Quarterly Report – Medicaid Expansion, Directed Payments, and Supplemental Payments Made to Hospitals SFY 2022, Quarter 4 Quarterly Report – Medicaid Expansion, Directed Payments, and Supplemental Payments Made to Hospitals SFY 2022, Quarter 3 Quarterly Report – Medicaid Expansion, Directed Payments, and Supplemental Payments Made to Hospitals SFY 2022, Quarter 2 Quarterly Report – Medicaid Expansion, Directed Payments, and Supplemental Payments Made to Hospitals SFY 2022, Quarter 1 Quarterly Report – Medicaid Expansion, Directed Payments, and Supplemental Payments Made to Hospitals SFY 2025, Quarter 2 -
Details:
- Medicaid
- Managed Care
Keywords: SCG, Managed Care 3.0, CSoC, DBPM, Transportation Manager, TM, system companion guide
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 MCE Taxonomy Crosswalk January – April MCE Taxonomy Crosswalk April – June MCE Taxonomy Crosswalk July – September -
Details:
- Medicaid Resources
- Medicaid
Medicaid 5-Year Strategic Plan & Appendix (Fiscal Years 2026-2031)
Downloadable Assets:
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Details:
- Legislative & Governmental Relations
- Medicaid
- Managed Care
This report is submitted under Act 210 of the 2013 Regular Legislative Session, which requires the Louisiana Department of Health (LDH) to submit an annual diabetes and obesity action plan to the Senate and House Committees on Health and Welfare after consulting with and receiving comments from the medical directors of each of its contracted Medicaid partners. Data presented on prevalence, utilization and costs of obesity and diabetes are based on 2023 paid healthcare claims submitted by each of the five Medicaid managed care organizations (MCOs) to Louisiana Medicaid and represent the Louisiana Medicaid managed care population only. Managed Care 3.0 Aetna, AmeriHealth Caritas, Healthy Blue, Humana, Louisiana Healthcare Connections, UnitedHealthcare Community Plan
Downloadable Assets:
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Details:
- Medicaid
- Managed Care
Louisiana Medicaid managed care contractors must meet the requirements of their contracts with LDH. If a contractor is non-compliant with contract requirements, LDH may apply administrative actions or assess monetary penalties and intermediate sanctions to obtain the level of performance required for successful operation of the managed care program. Keywords: MCO, health plan, noncompliance, administrative actions, non-compliance
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Details:
- Medicaid Rate Setting and Audit Resources
- Medicaid
Keywords: Intermediate Care Facility
Downloadable Assets:
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Details:
- Legislative & Governmental Relations
- Medicaid
- Managed Care
Response to Act 710 of the 2018 Regular Legislative Session Claims Report
Downloadable Assets:
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Details:
- Medicaid Rate Setting and Audit Resources
- Medicaid
- Adult Day Health Care (ADHC)
Reminder that annual cost reports (center and central office, if applicable) must be submitted by November 30, 2025. These reports cover the period of July 1, 2024, through June 30, 2025. Attached are the ADHC payment system rate calculations. The Direct Care Component amount for dates of service 7/1/2024 to 6/30/2025 was $2.08 per quarter hour increment. This amount will be needed to prepare the Direct Care cost settlement.
Downloadable Assets:
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Details:
- Medicaid Rate Setting and Audit Resources
- Medicaid
- Adult Day Health Care (ADHC)
Downloadable Assets:
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Details:
- Medicaid Rate Setting and Audit Resources
- Medicaid
- Nursing Home
Downloadable Assets:
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Details:
- Medicaid Rate Setting and Audit Resources
- Medicaid
Keywords: ICF, Intermediate Care Facility
Downloadable Assets:
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Details:
- Medicaid
Keywords: Eligibility Programs, Monthly Enrollment Trends
Downloadable Assets:
January 2025 - Medicaid Enrollment Trends Report February 2025 - Medicaid Enrollment Trends Report March 2025 - Medicaid Enrollment Trends Report April 2025 - Medicaid Enrollment Trends Report May 2025 - Enrollment Trends Report June 2025 - Enrollment Trends Report July 2025 - Medicaid Enrollment Trends Report August 2025 - Medicaid Enrollment Trends Report September 2025 - Medicaid Enrollment Trends Report October 2025 - Medicaid Enrollment Trends Report November 2025 - Medicaid Enrollment Trends Report