This text of Louisiana § 46:460.54 (Medicaid policies and procedures; procedure for adoption; required content) 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.
§460.54. Medicaid policies and procedures; procedure for adoption; required content
A.The department, prior to adopting, approving, amending, or implementing any
policy or procedure, shall publish the proposed policy or procedure on a publicly accessible
page of the department's website for a period of no less than forty-five days for the purpose
of soliciting public comments. The proposed policy or procedure shall be published in a
format to be determined by the department but shall include both the existing policy or
procedure and the proposed policy and procedure, with the proposed language in the text
printed in boldface type and underscored. All present policy or procedure language and
punctuation which are to be deleted shall be struck through.
B.A policy or procedure proposed by a
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§460.54. Medicaid policies and procedures; procedure for adoption; required content
A. The department, prior to adopting, approving, amending, or implementing any
policy or procedure, shall publish the proposed policy or procedure on a publicly accessible
page of the department's website for a period of no less than forty-five days for the purpose
of soliciting public comments. The proposed policy or procedure shall be published in a
format to be determined by the department but shall include both the existing policy or
procedure and the proposed policy and procedure, with the proposed language in the text
printed in boldface type and underscored. All present policy or procedure language and
punctuation which are to be deleted shall be struck through.
B. A policy or procedure proposed by a managed care organization shall not be
implemented unless the department has provided its express written approval to the managed
care organization after the expiration of the public notice period required by this Section.
C. If the department finds that an imminent peril to the public health, safety, or
welfare requires immediate approval of a proposed policy or procedure without otherwise
publishing the proposed policy or procedure as required in Subsection A of this Section, the
department may implement the proposed policy or procedure upon publishing a written
statement that details its reason for finding that an imminent peril to the public health, safety,
or welfare requires adoption of the proposed policy or procedure and a copy of the policy or
procedure.
D. The provisions of this Section shall not apply to any policy or procedure that is
otherwise duly promulgated in accordance with the Administrative Procedure Act or
included in a duly executed contract amendment.
E. The department or a managed care organization shall be prohibited from enforcing
any policy or procedure that is not adopted in compliance with this Section and any such
policy or procedure shall be null and void and considered a violation of the public policy of
this state.
F. If the managed care organization makes any policy or procedure change, the
managed care organization shall submit the changes to the department for approval within
the time specified by the department.
G. The department shall include in its Medicaid policies and procedures all of the
following information relating to telehealth:
(1) An exhaustive listing of the covered healthcare services which may be furnished
through telehealth.
(2) Processes by which providers may submit claims for reimbursement for
healthcare services furnished through telehealth.
(3) The conditions under which a managed care organization may reimburse a
provider or facility that is not physically located in this state for healthcare services furnished
to an enrollee through telehealth.