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This report was submitted to the Joint Legislative Committee on the Budget in accordance with House Concurrent Resolution (HCR) 2 of the 2025 Regular Legislative Session, prior to calculating, levying and collecting an assessment for each assessed hospital.
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This report is the eleventh in a series of annual reports produced by the Louisiana Department of Health (LDH or “the Department”) 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). 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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The Louisiana Children’s Health Insurance Program (LaCHIP) is an optional Medicaid program that provides healthcare coverage to uninsured children up to age 19 and enrollees in the LaCHIP Unborn Option (Phase IV) which provides prenatal care services, from conception to birth, for low income uninsured mothers who are not otherwise eligible for Medicaid.
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This report is written in response to House Resolution Number 292, 2025 Regular Session (H.R. 292), which requests that the Louisiana Department of Health (LDH) evaluate the current Louisiana Medicaid coverage and costs of CGM services for patients with GDM.
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Report from Louisiana Department of Health (LDH) on Medicaid continuity of care for premature newborns, analyzing rehospitalization rates under Act 311 oversight requirements.
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Milliman, Inc. has been retained by the Louisiana Department of Health (LDH) to provide actuarial and consulting services related to the development of capitation rates for the Healthy Louisiana managed care program. This report is an amendment to the capitation rates developed for state fiscal year (SFY) 2025. The previously certified capitation rates and documentation of their development were published in the State Fiscal Year 2025 Healthy Louisiana Medicaid Managed Care Capitation Rate Certification, dated November 27, 2024. Keywords: Managed Care 3.0, Capitation Rate, Certification-9-10-25
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Original Period Certified: July 2025 - June 2026. Actual Period Covered: July 2025 - Present. The Louisiana Department of Health (LDH) has contracted with Milliman, Inc. to develop actuarially sound capitation rate ranges for the Healthy Louisiana program. Rate certification letters certify universal rates for a given time period, e.g., a state fiscal year. Rates shown in these letters are not the rates actually paid to participating Managed Care Organizations (MCO), as the actual rates paid to each MCO are risk-adjusted. That is, the rates paid to each MCO are the universal rates in the rate letter as adjusted for the expected costs of that MCO’s enrolled members, based on the members’ health conditions and health status. Original rate letters are often replaced with revised rate letters for the same time period. Revisions are necessary whenever there are programmatic changes (e.g., changes in services or populations covered) that impact rates effective within the original rate letter time period. Revisions may cover the entire period or only part of the period (going forward from the effective date of a program change prior to the end the period); rate letters are also sometimes supplemented with an issue-specific companion certification. Keywords: Managed Care 3.0, Capitation Rate, Certification-8-18-25
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The standing order is issued in compliance with, and under the authority of, La. R.S. 40:978.2 and shall be deemed as a medical order for naloxone, or other opioid antagonist, as long as the conditions of the statute are met. This standing order shall be valid for one year from the date of issue below. Keywords: Pharmacy, substance abuse
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