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| Item Number | Policy/Procedure | Date Posted | Comment Period Closed | Status | Document Links |
|---|---|---|---|---|---|
| 2025-UHC-486 | Abnormal Uterine Bleeding and Uterine Fibroids | 10/6/25 | 11/20/25 | Pending | Abnormal Uterine Bleeding and Uterine Fibroids |
| 2025-UHC-793 | Virtual Upper Gastrointestinal Endoscopy | 10/6/25 | 11/20/25 | Pending | Virtual Upper Gastrointestinal Endoscopy |
| 2025-LHCC-1273 | Orthognathic Surgery | 10/6/25 | 11/20/25 | Pending | Orthognathic Surgery |
| 2025-LHCC-1277 | Panniculectomy | 10/6/25 | 11/20/25 | Pending | Panniculectomy |
| 2025-LHCC-1361 | Pediatric Heart Transplant | 10/6/25 | 11/20/25 | Pending | Pediatric Heart Transplant |
| 2025-LHCC-1741 | AHCT for Sickle Cell Anemia and Thalassemia | 10/6/25 | 11/20/25 | Pending | AHCT for Sickle Cell Anemia and Thalassemia |
| 2025-LHCC-1842 | Cosmetic and Reconstructive Procedures | 10/6/25 | 11/20/25 | Pending | Cosmetic and Reconstructive Procedures |
| 2025-UHC-2311 | Injectable Dermal Fillers and Bulking Agents | 10/6/25 | 11/20/25 | Pending | Injectable Dermal Fillers and Bulking Agents |
| 2025-LHCC-2749 | Radiation Therapy for Skin Cancer | 10/6/25 | 11/20/25 | Pending | Radiation Therapy for Skin Cancer |
| 2025-LHCC-1743 | Hospice Services | 9/29/25 | 11/13/25 | Pending | Hospice Services |
| 2025-LHCC-1959 | BH Treatment Documentation Requirements | 9/29/25 | 11/13/25 | Pending | BH Treatment Documentation Requirements |
| 2025-ABH-2536 | Community Brief Crisis Support (CBCS) and Behavioral Health Crisis Care (BHCC) Policy | 9/29/25 | 11/13/25 | Pending | Community Brief Crisis Support (CBCS) and Behavioral Health Crisis Care (BHCC) Policy |
| 2025-ABH-822 | ABH Provider Manual | 9/29/25 | 11/13/25 | Pending | ABH Provider Manual |
| 2025-ABH-1891 | Member Appeals | 9/29/25 | 11/13/25 | Pending | Member Appeals |
| 2025-ABH-1892 | Member Grievance | 9/29/25 | 11/13/25 | Pending | Member Grievance |
| 2025-LHCC-2476 | In Lieu Of Services Remote Patient Monitoring | 9/29/25 | 11/13/25 | Pending | In Lieu Of Services Remote Patient Monitoring |
| 2025-LHCC-1491 | NCCI Unbunding | 9/29/25 | 11/13/25 | Pending | NCCI Unbunding |
| 2025-LHCC-2530 | Transportation Policy | 9/29/25 | 11/13/25 | Pending | Transportation Policy |
| 2025-LHCC-687 | Measurable Progressive Improvement | 9/29/25 | 11/13/25 | Pending | Measurable Progressive Improvement |
| 2025-LHCC-931 | Appeals Process | 9/29/25 | 11/13/25 | Pending | Appeals Process |
| 2025-LHCC-1378 | Wheelchair Seating | 9/29/25 | 11/13/25 | Pending | Wheelchair Seating |
| 2025-LHCC-1410 | Neurofeedback for Behavioral Health Disorders | 9/29/25 | 11/13/25 | Pending | Neurofeedback for Behavioral Health Disorders |
| 2025-LHCC-1480 | Pre-operative Visits | 9/29/25 | 11/13/25 | Pending | Pre-operative Visits |
| 2025-LHCC-1908 | Community Brief Crisis Support | 9/29/25 | 11/13/25 | Pending | Community Brief Crisis Support |
| 2025-HUM-1922 | UM Home Health Clinical Coverage Policy | 9/29/25 | 11/13/25 | Pending | UM Home Health Clinical Coverage Policy |
| 2025-ABH-2254 | Benefit Exception Amendment | 9/29/25 | 11/13/25 | Pending | Benefit Exception Amendment |
| 2025-HUM-2565 | Drugs and Biologicals HCPCS | 9/29/25 | 11/13/25 | Pending | Drugs and Biologicals HCPCS |
| 2025-LHCC-2667 | MediTrans Claims Manual9/29/25 | 9/29/25 | 11/13/25 | Pending | MediTrans Claims Manual |
| 2025-ACLA-2727 | MH-IOP | 9/29/25 | 11/13/25 | Pending | MH-IOP |
| 2025-HUM-2728 | Correct Coding | 9/29/25 | 11/13/25 | Pending | Correct Coding |
| 2025-HUM-2729 | Correct Coding | 9/29/25 | 11/13/25 | Pending | Correct Coding |
| 2025-HUM-2740 | Anesthesia | 9/29/25 | 11/13/25 | Pending | Anesthesia |
| 2025-LHCC-1507 | Clinical Validation of Modifier 59 | 9/19/25 | 11/3/25 | Pending | Clinical Validation of Modifier 59 |
| 2025-LHCC-1509 | Clinical Validation of Modifier 25 | 9/19/25 | 11/3/25 | Pending | Clinical Validation of Modifier 25 |
| 2025-HUM-1644 | Eyebrow and Eyelid Repair | 9/19/25 | 11/3/25 | Pending | Eyebrow and Eyelid Repair |
| 2025-HUM-1661 | Molecular Diagnostic Assays and Breath Testing for Transplant Rejection Clinical Coverage Policy | 9/19/25 | 11/3/25 | Pending | Molecular Diagnostic Assays and Breath Testing for Transplant Rejection Clinical Coverage Policy |
| 2025-UHC-206 | Electric Tumor Treatment Field Therapy | 9/11/2025 | 10/26/2025 | Pending | Electric Tumor Treatment Field Therapy |
| 2025-UHC-222 | Skin and Soft Tissue Substitutes | 9/11/2025 | 10/26/2025 | Pending | Skin and Soft Tissue Substitutes |
| 2025-UHC-311 | Transcatheter Heart Valve Procedures | 9/11/2025 | 10/26/2025 | Pending | Transcatheter Heart Valve Procedures |
| 2025-UHC-379 | Brow Ptosis and Eyelid Repair | 9/11/2025 | 10/26/2025 | Pending | Brow Ptosis and Eyelid Repair |
| 2025-UHC-524 | Durable Medical Equipment, Orthotics, Medical Supplies and Repairs/Replacements | 9/11/2025 | 10/26/2025 | Pending | Durable Medical Equipment, Orthotics, Medical Supplies and Repairs/Replacements |
| 2025-UHC-558 | Surgery of the Knee | 9/11/2025 | 10/26/2025 | Pending | Surgery of the Knee |
| 2025-UHC-559 | Implantable Beta-Emitting Microspheres | 9/11/2025 | 10/26/2025 | Pending | Implantable Beta-Emitting Mocrospheres |
| 2025-UHC-561 | Cognitive Rehabilitation | 9/11/2025 | 10/26/2025 | Pending | Cognitive Rehabilitation |
| 2025-UHC-579 | Surgery of the Hip | 9/11/2025 | 10/26/2025 | Pending | Surgery of the Hip |
| 2025-UHC-1399 | Glaucoma Surgical Treatment | 9/11/2025 | 10/26/2025 | Pending | Glaucoma Surgical Treatment |
| 2025-UHC-1418 | Autologous Cellular Therapy | 9/11/2025 | 10/26/2025 | Pending | Autologous Cellular Therapy |
| 2025-UHC-1426 | Genetic Testing for Cardiac Disease | 9/11/2025 | 10/26/2025 | Pending | Genetic Testing for Cardiac Disease |
| 2025-UHC-2188 | Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials | 9/11/2025 | 10/26/2025 | Pending | Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials |
| 2025-UHC-2252 | Hospital Services: Observation and Inpatient | 9/11/2025 | 10/26/2025 | Pending | Clinical Policy Guidelines |
| 2025-ACLA-2745 | Clinical Policy Guidelines | 9/11/2025 | 10/26/2025 | Pending | Hospital Services: Observation and Inpatient |
| 2025-LHCC-690 | Outpatient Habilitative and Rehabilitative Speech Therapy | 9/3/25 | 10/18/25 | Pending | Outpatient Habilitative and Rehabilitative Speech Therapy |
| 2025-LHCC-1109 | Diaphragmatic/Phrenic Nerve Stimulation | 9/2/25 | 10/17/25 | Pending | Diaphragmatic/Phrenic Nerve Stimulation |
| 2025-LHCC-1228 | Sacroiliac Joint Interventions for Pain Management | 9/2/25 | 10/17/25 | Pending | Sacroiliac Joint Interventions for Pain Management |
| 2025-LHCC-1265 | Vagus Nerve Stimulation | 9/2/25 | 10/17/25 | Pending | Vagus Nerve Stimulation |
| 2025-LHCC-1271 | Implantable Hypoglossal Nerve Stimulation for OSA | 9/2/25 | 10/17/25 | Pending | Implantable Hypoglossal Nerve Stimulation for OSA |
| 2025-LHCC-1274 | Osteogenic Stimulation | 9/2/25 | 10/17/25 | Pending | Osteogenic Stimulation |
| 2025-LHCC-1284 | Preventive Health and Clinical Practice | 9/2/25 | 10/17/25 | Pending | Preventive Health and Clinical Practice |
| 2025-HBL-1311 | Bone Anchored and Bone Conduction Hearing Aids | 9/2/25 | 10/17/25 | Pending | Bone Anchored and Bone Conduction Hearing Aids |
| 2025-LHCC-1412 | Clinical Policy: Clinical Trials | 9/2/25 | 10/17/25 | Pending | Clinical Policy: Clinical Trials |
| 2025-LHCC-1524 | Posterior Tibial Nerve Stimulation for Voiding Dysfunction | 9/2/25 | 10/17/25 | Pending | Posterior Tibial Nerve Stimulation for Voiding Dysfunction |
| 2025-LHCC-1525 | Intradiscal Steroid Injections for Pain Management | 9/2/25 | 10/17/25 | Pending | Intradiscal Steroid Injections for Pain Management |
| 2025-LHCC-1526 | Trigger Point Injections | 9/2/25 | 10/17/25 | Pending | Trigger Point Injections |
| 2025-LHCC-1744 | Phototherapy for Neonatal Hyperbilirubinemia | 9/2/25 | 10/17/25 | Pending | Phototherapy for Neonatal Hyperbilirubinemia |
| 2025-LHCC-2225 | Lantidra (donislecel) Allogeneic Pancreatic Islet Cellular Therapy | 9/2/25 | 10/17/25 | Pending | Lantidra (donislecel) Allogeneic Pancreatic Islet Cellular Therapy |
Medicaid Managed Care Policies & Procedures
In accordance with La. R.S. 46:460.51, et seq., prior to adopting, approving, amending, or implementing certain policies or procedures, LDH will publish the proposed policy or procedure for the purpose of soliciting public comments. For this purpose, a policy or procedure, as defined by the statute, shall mean a requirement governing the administration of managed care organizations specific to billing guidelines, medical management and utilization review guidelines, case management guidelines, claims processing guidelines and edits, grievance and appeals procedures and process, other guidelines or manuals containing pertinent information related to operations and pre-processing claims, and core benefits and services.
The following table contains the LDH and managed care organization policies and procedures that are open for public comment.
RELATED INFO
- Previously posted for public comment
- Managed Care Policies & Procedures - Archive (2024)
- Managed Care Policies & Procedures - Archive (2023)
- Managed Care Policies & Procedures - Archive (2022)
- Managed Care Policies & Procedures - Archive (2021)
- Managed Care Policies & Procedures - Archive (2020)
- Managed Care Policies & Procedures - Archive (2019)
- MCO Managed Care Policies and Procedures Public Comments
- LDH Managed Care Policies and Procedures Public Comments