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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 2025 - Health Plan Enrollment by Subprogram February 2025 - Health Plan Enrollment by Subprogram April 2025 - Health Plan Enrollment by Subprogram May 2025 - Health Plan Enrollment by Subprogram June 2025 - Health Plan Enrollment by Subprogram July 2025 - Health Plan Enrollment by Subprogram August 2025 - Health Plan Enrollment by Subprogram September 2025 - Health Plan Enrollment by Subprogram October 2025 - Health Plan Enrollment by Subprogram November 2025 - Health Plan Enrollment by Subprogram December 2025 - Health Plan Enrollment by Subprogram -
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 New Enrollment March 2025 - Health Plan New Enrollment February 2025 - Health Plan New Enrollment April 2025 - Health Plan New Enrollment May 2025 - Health Plan New Enrollment June 2025 - Health Plan New Enrollment July 2025 - Health Plan New Enrollment August 2025 - Health Plan New Enrollment September 2025 - Health Plan New Enrollment October 2025 - Health Plan New Enrollment November 2025 - Health Plan New Enrollment December 2025 - Health Plan New Enrollment -
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 July 2025 - Auto Assignment by Health plan and Source August 2025 - Auto Assignment by Health plan and Source September 2025 - Auto Assignment by Health plan and Source October 2025 - Auto Assignment by Health plan and Source November 2025 - Auto Assignment by Health plan and Source December 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
Downloadable Assets:
January 2025 - Health Plan Changes by Plan March 2025 - Health Plan Changes by Plan February 2025 - Health Plan Changes by Plan April 2025 - Health Plan Changes by Plan May 2025 - Health Plan Changes by Plan June 2025 - Health Plan Changes by Plan July 2025 - Health Plan Changes by Plan August 2025 - Health Plan Changes by Plan September 2025 - Health Plan Changes by Plan October 2025 - Health Plan Changes by Plan November 2025 - Health Plan Changes by Plan December 2025 - Health Plan Changes by Plan -
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 MCE Taxonomy Crosswalk January – April MCE Taxonomy Crosswalk April – June MCE Taxonomy Crosswalk July – September MCE Taxonomy Crosswalk September – December Change Control Table 2025 -
Details:
- Medicaid
- Pharmacy
Preferred Drug List July 1, 2025 Version 3
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Details:
- Medicaid
- Pharmacy
ICD-10 Diagnosis Code Chart January 1, 2025 Version 5
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Details:
- Medicaid
- Managed Care
Keywords: Managed Care, DBPM
Downloadable Assets:
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Details:
- Medicaid
- Managed Care
The Louisiana Department of Health (LDH) assesses the perceptions and experiences of adult and child members enrolled in the managed care organizations (MCOs) as part of its process for evaluating the quality of health care services provided to adult and child members in the Louisiana Medicaid Managed Care Program. This report presents the 2025 (Measurement Year 2024) CAHPS results of adult members and the parents/caretakers who completed the survey on behalf of child members enrolled in an MCO. Keywords: Experience of Care.
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Details:
- Medicaid
The Louisiana Department of Health is issuing this RFI for the purpose of gathering information and cost estimates from qualified entities with demonstrated capacity and experience to administer and operate a consolidated Call Center. The information gathered will help inform LDH in developing a comprehensive Scope of Services for a potential future Request for Proposal (RFP).
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Details:
- Medicaid
The Louisiana Department of Health (LDH) has issued a request for information (RFI) to solicit information from qualified and experienced vendors regarding available electronic visit verification (EVV) and data aggregator solutions and their ability to comply with federal and state requirements for verifying home and community-based services. The purpose of an EVV system is to confirm that individuals are receiving the services authorized in their care plans, prevent improper billing or payments, protect against fraud and enhance program oversight. This RFI aims to collect details on system capabilities, integration options, security standards, and implementation timelines.
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