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LDH Resources
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- Behavioral Health
- Medicaid Resources
- Medicaid
- Managed Care
- Coordinated System of Care
Behavioral Health Services Encounter Study 2023 Q1 for the reporting period January 2023 through March 2023 Keywords: Managed Care 3.0 CSoC, Magellan, OBH, Behavioral Health
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- Medicaid
- Managed Care
The Independent Review process was established to resolve claims disputes when a provider believes a managed care organization has partially or totally denied claims incorrectly. The Louisiana Department of Health administers the independent review process, but does not perform the independent review of the disputed claims.
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- Medicaid Rate Setting and Audit Resources
- Medicaid
- Adult Day Health Care (ADHC)
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- Medicaid Rate Setting and Audit Resources
- Medicaid
- Adult Day Health Care (ADHC)
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- Legislative & Governmental Relations
- Medicaid
In response to Act 207 (SB 305) of the 2003 Regular Session, LDH is required to submit certain information regarding the Medicaid Buy-In Program to the legislature, including the status of the buy-in program, a report relative to the estimated value of the state, federal and FICA taxes paid by the participants in the buy-in program, and any recommendations for expanding coverage in the buy-in program.
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- Medicaid
- Pharmacy
Keywords: PDL, Diabetes, Diabetic PDL
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- Medicaid
- Pharmacy
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- Legislative & Governmental Relations
- Medicaid
- Managed Care
This report is the tenth in a series of annual reports produced by the Louisiana Department of Health (LDH) to satisfy statutory reporting requirements intended to ensure the following outcomes are being achieved by Louisiana’s Medicaid managed care program (R.S. 40:1253.2). For the first six months of SFY 2023 (July – December 2022), five MCOs were contracted with LDH to manage physical and behavioral healthcare services. Effective January 1, 2023, the state began a new three-year contract for all continuing MCOs and added Humana as the sixth health plan. All data presented in this report for Humana is for the six months of operations, January 1 – June 30, 2023: Aetna Better Health, Inc. (ABH); AmeriHealth Caritas Louisiana, Inc. (ACLA); Community Care Plan of Louisiana, Inc. (dba Healthy Blue) (HBL); Humana Health Benefit Plan of Louisiana, Inc. (dba Humana Healthy Horizons in Louisiana) (HHH); Louisiana Healthcare Connections, Inc. (LHCC); and UnitedHealthcare of Louisiana, Inc. (UHC).
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- Legislative & Governmental Relations
- Medicaid
Senate Bill (SB) 259 of the 2022 Regular Legislative Session, known as the Public Benefit Integrity Law, requires annual reports from state agencies that administer federal and state social services and financial assistance programs. The reports must address policies and procedures in place to enhance program integrity and eliminate fraud, waste, and abuse of federal and state resources.
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- Legislative & Governmental Relations
- Medicaid
- Managed Care
The Louisiana Department of Health (LDH) is mandated to produce and submit the Healthy Louisiana Claims Report to the Joint Legislative Committee on the Budget, as well as the House and Senate Committees on Health and Welfare.
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- Medicaid Rate Setting and Audit Resources
- Medicaid
Keywords: School-based Medicaid Program
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- Medicaid Rate Setting and Audit Resources
- Medicaid
Keywords: School-Based Medicaid Program
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