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Amends the provisions governing the Pharmacy Benefit Management Program in order to align the language in the Louisiana Administrative Code relative to drugs excluded from Medicaid coverage with the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services -approved State Plan amendment.
Repeals inpatient hospital services Rules which were promulgated prior to implementation of the Louisiana Administrative Code (LAC) codification system and amends the provisions governing inpatient hospital services in order to promulgate the criteria to qualify for reimbursement as a distinct part psychiatric unit in a codified format in the LAC and add qualifying criteria for rehabilitation, long-term, and freestanding hospitals.
Amends the provisions governing children’s and adult mental health services to expand the mental health professionals eligible to provide therapeutic services to include provisionally licensed professional counselors, provisionally licensed marriage and family therapists, and licensed master social workers.
Amends the provisions governing the Community Choices Waiver to update the individuals approved to be personal assistance service workers and monitored in-home caring principal caregivers, permit monitored in-home caregiving participants to receive adult day health care services simultaneously, and add financial management services as a new service when participants choose the self-direction option in order to align the administrative Rule with the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services approved waiver amendment.
Amends the provisions governing the Program of All Inclusive Care for the Elderly (PACE) in order to require that a PACE organization/provider have a personal care attendant (PCA) home and community-based services license in addition to the required adult day health care license if the organization/provider does not contract with a PCA agency, and updates language in order to reflect current practices and terminology.
Amends the provisions governing the reimbursement methodology for ambulatory surgical centers (ASCs) in order to allow qualified ASCs to bill for services provided to Medicaid beneficiaries at the outpatient hospital rate and be reimbursed on the current Louisiana State University enhanced fee schedule.
Amends the provisions governing leave of absence days for intermediate care facilities for persons with intellectual disabilities (ICFs/IID) in order to increase the total leave days for ICF/IID clients from 45 to 60 and from 30 consecutive days in any single occurrence to 45 consecutive days.
Amends the provisions governing inpatient hospital services to clarify the purpose of the affiliated agreement that hospitals must have with an accredited institution for major or minor teaching hospital graduation education training and the options applicable for residency programs in order to align the administrative Rule with the current State Plan Amendment approved by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Continues the provisions of the November 09, 2023 Emergency Rule which extended the expiration date for health status monitoring, home delivered meals, activity and sensor monitoring, and personal emergency response systems that were initially added to the Adult Day Health Care waiver as temporary services during the Coronavirus Disease 2019 (COVID-19) public health emergency (PHE) and were extended beyond the May 11, 2023 PHE end date as allowed by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Amends the provisions governing disproportionate share hospital payments to establish the qualification criteria and methodology for payments for the uncompensated care costs of inpatient psychiatric hospitals located in the northern area of the state with an academic training mission for services provided to uninsured and low-income individuals from the payment pool created in accordance with Act 447 of the 2023 Regular Session of the Louisiana Legislature.
Continues the provisions of the October 1, 2023 Emergency Rule, which amended the provisions governing the standards for payment and reimbursement for nursing facilities in order to implement the required transition from the current resource utilization group (RUG-III/RUG-IV) case-mix classification model used under the Medicare skilled nursing facility prospective payment system to the patient driven payment model which was delayed by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services until October 1, 2023 due to the COVID-19 public health emergency and to mandate use of the optional state assessment.
Continues the provisions of the December 1, 2023 Emergency Rule, which amended the provisions in the Medical Transportation Program governing American Rescue Plan Act (ARPA) bonus payments to providers of non-emergency medical transportation (NEMT) services in order to establish the guidelines the department will utilize to oversee the administration and distribution of ARPA bonus payment funds to eligible NEMT providers by the Medicaid managed care organizations.