RULEMAKING: Medicaid - Notices of Intent

December 11, 2017
Amends the provisions governing the reimbursement methodology for intermediate care facilities for persons with intellectual disabilities in order to repeal the provisions of the April 20, 2017 Rule, which established and set upper payment limits for supplemental Medicaid payments to private intermediate care facilities that enter into a cooperative endeavor agreement with the department, due to the withdrawal of the corresponding State Plan amendment from U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services consideration.
December 08, 2017
Amends the provisions governing inpatient hospital services in order to repeal provisions requiring pre-certification, concurrent review, and length of stay assignment for admission of Medicaid recipients to non-state and state operated acute care general hospitals due to the implementation of managed care through the Healthy Louisiana program.
December 08, 2017
Amends the provisions governing hospice licensing standards in order clarify and update these provisions to be consistent with other licensing Rules and processes and to ensure that they are promulgated in a clear and concise manner in the Louisiana Administrative Code.
December 08, 2017
Amends the provisions governing family planning services to remove the limitation on office visits for physical examinations for family planning and family planning-related services to align the Medicaid State Plan with the State Plan amendment governing Medicaid expansion, in compliance with U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services requirements.
November 14, 2017
Amends the provisions governing therapeutic group homes (TGH) in order to: 1) reflect the coordinated system of care (CSoC) contractor moving from a non-risk contract to a full-risk capitated contract; 2) remove the requirement for the Office of Behavioral Health certification of providers; and 3) reflect that TGH are carved out of management by the CSoC contractor to align with current practice and contract requirements.
November 14, 2017
Amends the provisions governing the licensing standards for psychiatric residential treatment facilities in order to: 1) revise the definition and qualifications for mental health specialists; 2) establish provisions for inactivation of licensure due to non-declared disasters or emergencies; 3) clarify requirements for social media use and reporting; and 4) ensure consistency with other licensing Rules, regulations and processes.
November 14, 2017
Amends provisions governing managed care for physical and behavioral health in order to align the current Rule with the Code of Federal Regulations and the Louisiana Administrative Code which will: 1) revise timeframes for members to initiate state fair hearings and request appeals; 2) revise the timeframe for managed care organizations to resolve grievances; 3) update definitions to align with federal Rule changes; 4) revise record retention requirements; and 5) clarify reporting requirements.
November 14, 2017
Amends the provisions governing managed care for physical and behavioral health in order to adopt provisions for an independent review process for healthcare providers who have received an adverse determination on managed care organization claims payments.
November 14, 2017
Amends the provisions governing laboratory and radiology services to terminate coverage and reimbursement of proton beam radiation therapy for recipients 21 years of age and older.
November 14, 2017
Amends provisions governing children’s behavioral health services provided through the Home and Community-Based Behavioral Health Services Waiver in order to: 1) reflect the coordinated system of care contractor moving from a non-risk contract to a full-risk capitated contract; and 2) remove the requirement for the Office of Behavioral Health certification of providers.