This text of Louisiana § 40:1259.2 (Medicaid coverage for perimenopausal and menopausal care) is published on Counsel Stack Legal Research, covering Louisiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
§1259.2. Medicaid coverage for perimenopausal and menopausal care
A.The Louisiana Medicaid program shall cover inpatient and, if deemed appropriate,
outpatient coverage for perimenopausal or menopausal treatment or care when such care or
treatment is used for a medically accepted indication and administered in any healthcare
facility by any healthcare professional appropriately licensed in this state to provide such
medical treatment or care in accordance with state and federal guidelines or certifications.
B.Any healthcare facility appropriately providing perimenopausal or menopausal
treatment or care in accordance with state and federal guidelines or certifications that
participates in the Louisiana Medicaid program shall provide perimenopausal or menopausal
treatment or care to an ind
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§1259.2. Medicaid coverage for perimenopausal and menopausal care
A. The Louisiana Medicaid program shall cover inpatient and, if deemed appropriate,
outpatient coverage for perimenopausal or menopausal treatment or care when such care or
treatment is used for a medically accepted indication and administered in any healthcare
facility by any healthcare professional appropriately licensed in this state to provide such
medical treatment or care in accordance with state and federal guidelines or certifications.
B. Any healthcare facility appropriately providing perimenopausal or menopausal
treatment or care in accordance with state and federal guidelines or certifications that
participates in the Louisiana Medicaid program shall provide perimenopausal or menopausal
treatment or care to an individual who is eligible for such enrollment as defined in
Subsection C of this Section.
C.(1) To receive coverage from the Louisiana Medicaid program for perimenopausal
or menopausal treatment or care, the eligibility of a prospective enrollee shall be determined
by the healthcare facility appropriately providing perimenopausal or menopausal treatment
or care in accordance with state and federal guidelines or certifications as provided in
Subsection B of this Section.
(2) A prospective enrollee shall be considered eligible for perimenopausal or
menopausal treatment or care enrollment if the individual satisfies all of the following
qualifications:
(a) The individual is enrolled in the Louisiana Medicaid program.
(b) A licensed healthcare provider has certified that perimenopausal or menopausal
treatment or care is medically necessary and appropriate to treat the individual's condition.
(c) The perimenopausal or menopausal treatment or care is administered in any
healthcare facility appropriately providing perimenopausal or menopausal treatment or care
in accordance with state and federal guidelines or certifications.
D. Pursuant to this Section, the secretary of the Louisiana Department of Health shall
do all of the following:
(1) Submit to the Centers for Medicare and Medicaid Services all necessary state
plan amendments.
(2) Promulgate all necessary rules and regulations in accordance with the
Administrative Procedure Act.
(3) Take any other actions necessary to implement the provisions of this Section.