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LDH Resources
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Details:
- Medicaid
- Managed Care
Keywords: Bayou Health, Maximus, Managed Care 3.0, Aetna Better Health, ABH, Healthy Blue, HBL, AmeriHealth Caritas, ACLA, Louisiana Healthcare Connections, LHCC, UnitedHealthcare Community Plan, UHC, Humana Healthy Horizons, HHH, enrollment report
Downloadable Assets:
January 2025 - Health Plan Enrollment by Subprogram without Medicaid Expansion 2025 - Health Plan Enrollment by Subprogram without Medicaid Expansion February 2025 - Health Plan Enrollment by Subprogram without Medicaid Expansion April 2025 - Health Plan Enrollment by Subprogram without Medicaid Expansion May 2025 - Health Plan Enrollment by Subprogram without Medicaid Expansion June 2025 - Health Plan Enrollment by Subprogram without Medicaid Expansion -
Details:
- Medicaid
- Managed Care
Keywords: Bayou Health, Maximus, Managed Care 3.0, Aetna Better Health, ABH, Healthy Blue, HBL, AmeriHealth Caritas, ACLA, Louisiana Healthcare Connections, LHCC, UnitedHealthcare Community Plan, UHC, Humana Healthy Horizons, HHH, enrollment report
Downloadable Assets:
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Details:
- Medicaid
- Managed Care
Keywords: Bayou Health, Maximus, Managed Care 3.0, Aetna Better Health, ABH, Healthy Blue, HBL, AmeriHealth Caritas, ACLA, Louisiana Healthcare Connections, LHCC, UnitedHealthcare Community Plan, UHC, Humana Healthy Horizons, HHH, enrollment report
Downloadable Assets:
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Details:
- Medicaid
- Managed Care
Keywords: Bayou Health, Maximus, Managed Care 3.0, Aetna Better Health, ABH, Healthy Blue, HBL, AmeriHealth Caritas, ACLA, Louisiana Healthcare Connections, LHCC, UnitedHealthcare Community Plan, UHC, Humana Healthy Horizons, HHH, enrollment report
Downloadable Assets:
January 2025 - Auto Assignment by Health plan and Source March 2025 - Auto Assignment by Health plan and Source February 2025 - Auto Assignment by Health plan and Source April 2025 - Auto Assignment by Health plan and Source May 2025 - Auto Assignment by Health plan and Source June 2025 - Auto Assignment by Health plan and Source -
Details:
- Medicaid
- Managed Care
Keywords: Bayou Health, Maximus, Managed Care 3.0, Aetna Better Health, ABH, Healthy Blue, HBL, AmeriHealth Caritas, ACLA, Louisiana Healthcare Connections, LHCC, UnitedHealthcare Community Plan, UHC, Humana Healthy Horizons, HHH, enrollment report, enrollment reports
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Details:
- Medicaid
- Managed Care
Keywords: SCG, Managed Care 3.0, CSoC, DBPM, Transportation Manager, TM, system companion guide
Downloadable Assets:
System Companion Guide Change Control Table Appendix A: Acronyms, Definitions and Data Elements Appendix B: Frequently Asked Questions Appendix C: Code Sets Appendix D: MCE Onboarding and Encounter Testing - How to be an MCE Appendix E: EDI Test Plan and File Exchange Schedule Appendix F: System Generated Files and Reports Appendix G: Helpful Websites Appendix H: 820 File - FI to MCO Appendix I: MCE SCG Links to Other Documents Appendix J: Medicaid MMIS Claims and Encounter Inquiry Procedure Dental Plan Comparison Chart Behavioral Health Provider Types and Specialties Non-EDI File Layout Behavioral Health and SMO Non-EDI File Layout Transportation Non-EDI File Layout EDI Annual Certification of Electronic Files Form Annual EDI Cover Letter Encounter Data Certification Form EDI Transmission Research Request Form - Gainwell MCE Registration To Do List MCE Testing Protocol MCO Registration Packet MES Inquiry Request Form TPL Links to Update Recipient Insurance Edits Comprehensive, Repairable and Non-Repairable MCE Tables Behavioral Health and Dental SMO non-EDI File Layout -
Details:
- Medicaid
- Managed Care
Louisiana Medicaid managed care contractors must meet the requirements of their contracts with LDH. If a contractor is non-compliant with contract requirements, LDH may apply administrative actions or assess monetary penalties and intermediate sanctions to obtain the level of performance required for successful operation of the managed care program. Keywords: MCO, health plan, noncompliance, administrative actions, non-compliance
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Details:
- Legislative & Governmental Relations
- Medicaid
- Managed Care
Response to Act 710 of the 2018 Regular Legislative Session Claims Report
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Details:
- Medicaid
- Managed Care
In accordance with 42 CFR § 438.66(e), LDH submits an annual report to CMS on each managed care program administered by the State. The annual report is a component of CMS’ overall strategy to improve access to services by supporting Federal and State access monitoring for Medicaid beneficiaries within a managed care delivery system. Keywords: MCPAR
Downloadable Assets:
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Details:
- Medicaid
- Managed Care
In accordance with 42 CFR § 438.66(e), LDH submits an annual report to CMS on each managed care program administered by the State. The annual report is a component of CMS’ overall strategy to improve access to services by supporting Federal and State access monitoring for Medicaid beneficiaries within a managed care delivery system. Keywords: MCPAR
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Details:
- Medicaid
- Pharmacy
FFS Medicaid Maintenance Drug List Q2 2025
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