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Continues the provisions of the October 1, 2014 Emergency Rule which rescinded the provisions of the November 1, 2012 Emergency Rule governing the reimbursement methodology for services rendered in the Pharmacy Benefits Management Program, and returned to the reimbursement rates in effect on September 5, 2012 which is consistent with the currently approved Medicaid State Plan.
Continues the provisions of the February 12, 2015 Emergency Rule which amended the provisions governing the reimbursement methodology for outpatient hospital services rendered by non-rural, non-state hospitals in order to adopt a supplemental payment methodology for services provided by hospitals located in LDH Administrative Region 8 in the Monroe area.
Continues the provisions of the February 12, 2015 Emergency Rule which amended the provisions governing outpatient hospital services rendered by non-rural, non-state hospitals in order to adopt a supplemental payment methodology for services provided by hospitals located in the Baton Rouge area.
Continues the provisions of the February 12, 2015 Emergency Rule which adopted a supplemental payment methodology for outpatient hospital services rendered by children’s specialty hospitals in the New Orleans area.
Continues the provisions of the October 1, 2014 Emergency Rule which amended the provisions governing the transitional rates for public facilities in order to increase the Medicaid reimbursement rate.
Continues the provisions of the February 12, 2015 Emergency Rule which amended the provisions governing the reimbursement methodology for inpatient hospital services rendered by non-rural, non-state hospitals in order to adopt a supplemental payment methodology for services provided by hospitals located in LDH administrative region 8 in the Monroe area.
Continues the provisions of the February 12, 2015 Emergency Rule which amended the provisions governing inpatient hospital services rendered by non-rural, non-state hospitals in order to adopt a supplemental payment methodology for services provided by hospitals located in the Baton Rouge area.
Continues the provisions of the February 12, 2015 Emergency Rule which adopted a supplemental payment methodology for inpatient hospital services rendered by children’s specialty hospitals in the New Orleans area.
Amends the provisions governing the Professional Services Program in order to revise the reimbursement methodology for services rendered by physicians and other professional services practitioners employed by, or under contract to provide services in affiliation with a state-owned or operated entity.
Amends the provisions governing reimbursement for professional services in the Medical Assistance Program in order to establish provisions for the enhanced one percent Federal Medical Assistance Percentage rate increase for the coverage of specified preventive services.
Amends the provisions governing managed care for physical and behavioral health in order to allow Medicaid recipients enrolled in the LaHIPP Program to access behavioral health services only through the managed care organizations that participate in the Healthy Louisiana (formerly Bayou Health) Program.
Amends the provisions governing the Pharmacy Benefits Management Program in order to clarify the provisions of the January 20, 2017 Notice of Intent and to: 1) revise the definitions for usual and customary charge and general public; 2) clarify billing/reimbursement requirements for 340B entities that are carved-out of Medicaid; 3) revise the reimbursement language for Federal Supply Schedule and Nominal Price; 4) revise the definition for contract pharmacy; and 5) clarify professional dispensing fee provisions.