Results for provider policy

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  Health Standards Section

  Has responsibility for the licensing of all healthcare facilities in the State of Louisiana that are subject to licensing statutes.

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  Bureau of Community Partnerships & Health Equity

  Focused on health equity and ensuring LDH’s services are equitably accessible and informed by the people, populations and communities it serves.

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  Bureau of Nutrition Services

  Provides foods, nutrition counseling, breastfeeding promotion, breastfeeding support and access to health services to low-income women, infants, and children.

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  Bureau of Family Health

  The Bureau of Family Health works to promote optimal health for all Louisiana women, children, teens and families.

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  Bureau of Emergency Medical Services (EMS)

  Responsible for the overall planing, coordination, licensing and regulation of Louisiana's EMS system.

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  Office on Women’s Health and Community Health

  Dedicated to improving women's health outcomes and serve as a clearing house, coordinating agency and resource center for women's health data and strategies.

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  Bureau of Health Informatics

  To inform and facilitate efforts to improve the health of Louisiana communities through strategic collection, analysis and presentation of available data.

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  Office for Citizens with Developmental Disabilities

  Single Point of Entry into the developmental disabilities services system and oversees public/private residential services for people with disabilities.

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  Bureau of Chronic Disease Prevention & Healthcare Access

  The Bureau of Chronic Disease Prevention and Healthcare Access within the Louisiana Department of Health is known in the community as Well-Ahead Louisiana.

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  HB 291, Act 367: Provides for Visitation Policies at Certain Healthcare Facilities

  HB 291, Act 367: Provides for Visitation Policies at Certain Healthcare Facilities

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  Policy Research and Health Systems Analysis

  Vision: Information for making optimal data-driven decisions is readily available and utilized to drive decisions that support the accomplishment of health goals, shapes policies, and assure cost effective systems that provide positive outcomes.

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  For Healthcare and Public Health Professionals

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  Opioid Toolkits

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  Managed Care Pharmacy and Medical Drug Policies

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  Louisiana Sickle Cell Disease Registry

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  EMS Education

  The State of Louisiana requires that Emergency Medical Services (EMS) personnel adhere to the strictest standards of quality as it relates to education, training, testing, and service. To insure these efforts, Louisiana requires certification by the National Registry of Emergency Medical Technicians (NREMT) as a prerequisite for licensure at every license level, except for the Emergency Medical Responder (EMR).

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  USDA Non-Discrimination Statement

  In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.

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  About Coordinated System of Care (CSoC)

  In Louisiana, we have developed the Coordinated System of Care (CSoC), an approach to offering behavioral healthcare services for children/youth and their families that is based on a system of care values. Specific goals for CSoC include decreasing the number of youth in residential/detention settings, reducing the state's cost for providing services by leveraging Medicaid and other funding sources, and improving the overall outcomes for these children/youth and their caregivers.

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  2018 Managed Care Transparency Report

  Managed Care 2.0 Amerigroup Healthy Blue AmeriHealth Caritas Louisiana Healthcare Connections UnitedHealthcare Community Plan Aetna Better Health This report is the seventh in a series produced by the Louisiana Department of Health (LDH or “the Department”) to satisfy statutory reporting requirements intended to ensure the following outcomes are being achieved by Louisiana’s Medicaid Managed Care Program (R.S. 40:1253.2):  improved care coordination with patient‐centered medical homes for Medicaid enrollees;  improved health outcomes and quality of care;  increased emphasis on disease prevention and the early diagnosis and management of chronic conditions;  improved access to Medicaid services;  improved accountability with a decrease in fraud, abuse and wasteful spending; and  a more financially stable Medicaid program. Beginning in February of 2012, the original Medicaid Managed Care Program included two models of coordinated care networks: full‐risk managed care organizations (MCOs) known as prepaid health plans, and primary care case management (PCCM) known as shared savings plans. The state contracted with three prepaid and two shared savings plans, and individuals were given the option of choosing the plan that best met their needs. However, not all Medicaid services were available from health plans, and some health plan members continued to receive certain services under the fee‐for‐service program. In addition, many individuals covered by Medicaid were not eligible to enroll in and receive services from a health plan. LDH has progressively integrated services and populations into the Medicaid Managed Care Program. The following timeline includes major milestones in the growth of the managed care program:  Pharmacy benefits were “carved‐in” to the prepaid plan benefit package on November 1, 2012.  Dental benefits have been provided to all Medicaid populations under a single Dental Benefits Program Manager (DBPM) since July 1, 2014.  The delivery model was transitioned from three full‐risk MCOs and two shared‐savings PCCMs to five full‐risk MCOs on February 1, 2015.  Hospice benefits were added on February 1, 2015.  Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) ‐ Personal Care Services were added on February 1, 2015.  Retroactive linkages to a Medicaid managed care plan were implemented on February 1, 2015.  Specialized behavioral health benefits were added on December 1, 2015.  Eligibility for Medicaid services was expanded to include the new adult population on July 1, 2016. Medicaid Expansion On July 1, 2016, the state expanded eligibility for the Louisiana Medicaid program to include adults ages 19 to 64 years old with incomes at or below 138% of the federal poverty level. In State Fiscal Year 2018, 587,912 unduplicated members were enrolled in a managed care plan through the expansion. In this transparency report, the expansion population is included in the reporting for full‐benefit members. Additional information specific to the new adult expansion population can be found on the “LDH Medicaid Expansion Dashboard” at http://www.ldh.la.gov/HealthyLaDashboard/. Transparency Report Measures and Data This report includes 27 measures as outlined in La. Revised Statute 40:1253.2. It covers program operations for July 2017 through June 2018 (State Fiscal Year 2018), except for the following measures which are reported on a calendar year basis per the contract between the Department and the managed care entities: Section 7 – Medical Loss Ratio Section 8 – Health Outcomes Section 9 – Member and Provider Satisfaction Surveys Section 10 – Audited Financial Statements Section 25 – Medicaid Drug Rebates Information included in this report was collected from multiple sources. To the greatest extent possible, the data are extracted from state systems that routinely collect and maintain operational data on the Medicaid Managed Care Program. When unavailable from state sources, data were collected from the managed care entities or sourced from either routine reporting deliverables1 or ad hoc reports requested specifically for this purpose. The Medicaid Management Information System (MMIS) and the Management Administrative Reporting Subsystem (MARS Data Warehouse or MDW) are maintained by the Medicaid program’s contracted fiscal intermediary, DXC Technologies (DXC), formerly Molina Healthcare. Detailed enrollee and provider information, as well as claims payment data for this report, were extracted from the MARS data warehouse. The state administrative system, called ISIS, maintained by the Office of Technology Services within the Division of Administration, was used to extract information on payments to the MCOs and Dental Benefits Plan Manager. As part of routine operations and as required by the Centers for Medicare and Medicaid Services (CMS), internal policies and procedures for collection of data were validated by the Department’s contracted external quality review organization (EQRO), Island Peer Review Organization (IPRO). In addition to standing operational quality assurances and EQRO reviews, the data included in this report were independently validated by Myers and Stauffer, an audit contractor of the Department. Myers and Stauffer reviewed for reasonability the data extraction code or process that the managed care entities or the Department used to generate data. For data originating from the MARS Data Warehouse or MMIS, Myers and Stauffer generated its own data from encounters or data extracts for each plan and compared its results to the results the Department produced. For data originating from the plans, Myers and Stauffer reviewed plan responses to a survey developed by Myers and Stauffer to document the process the plans used to generate the data, as well as policies and procedures in place to collect, track and report data. Where Myers and Stauffer found inconsistencies above or below the 10% variance threshold established by the Department, they made recommendations to the Department and/or the health plan to improve the method used to collect data. See Appendix XII for the survey instrument.

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  NATP New Program Application Packet

  Information and instructions for requesting approval of NATP