Louisiana Administrative Code

A. The 2001 CSO Mortality Table, or its successor table adopted by the NAIC and detailed in VM-20, may be used in applying Regulation 85 in the following manner, subject to the transition dates for use of the 2001 CSO Mortality Table, or its successor table adopted by the NAIC an…

A. For any ordinary life insurance policy delivered or issued for delivery in this state on and after January 1, 2005, through December 31, 2016, that utilizes the same premium rates and charges for male and female lives or is issued in circumstances where applicable law does not…

A. If any provision of this regulation or its application to any person or circumstance is for any reason held to be invalid, the remainder of the regulation and the application of the provision to other persons or circumstances shall not be affected.

A. This regulation shall take effect upon final publication in the Louisiana Register.

A. Reimbursement for case management services for the Infant and Toddler Program (EarlySteps): 1. Effective for dates of service on or after July 1, 2022, case management services provided to participants in the EarlySteps Program shall be reimbursed at a flat rate for each appro…

A. For recipients enrolled with the CSoC contractor, reimbursement for services shall be based upon the established Medicaid fee schedule for behavioral health services. For recipients enrolled in one of the MCOs, the department or its fiscal intermediary shall make monthly capit…

A. Case management agencies shall provide annual cost reports based on the state fiscal year, July 1 through June 30. Completed reports are due within 90 calendar days after the end of each state fiscal year or by September 28 of each calendar year.

A. Establishment of Targeted Case Management Workforce Retention Bonus Payments 1. Case management agencies for the early and periodic screening, diagnosis, and treatment (EPSDT) targeted population and for participants in the New Opportunities Waiver (NOW) who provided services …

A. In-state publicly and privately owned and operated PRTFs shall be reimbursed for covered PRTF services according to the following provisions. The rate paid by the MCO or the CSoC contractor shall take into consideration the following ownership and service criteria: 1. free-sta…

A. Out-of-state PRTFs shall be reimbursed in accordance with the MCO or CSoC contractor’s established rate.

A. Payments for Medicaid covered services will be made under a prospective payment system (PPS) and paid on a per visit basis. B. A visit is defined as a face-to-face encounter between a facility health professional and a Medicaid eligible patient for the purpose of providing med…

A. Effective for dates of service on or after October 20, 2007, the Medicaid Program establishes an alternate payment methodology for adjunct services provided by federally qualified health centers (FQHCs) when these professional services are rendered during evening, weekend or h…

A. Medicaid utilizes the income and asset methodologies of the Supplemental Security Income (SSI) Program to determine Medicaid eligibility for aged, blind and disabled individuals. B. Under Section 1902(r)(2) of the Social Security Act, states are allowed to use less restrictive…

A. In compliance with the Deficit Reduction Act, individuals who are insured under a long-term care insurance policy that meets the requirements of a “qualified state long-term care insurance partnership” policy shall receive a disregard of resources equal to the amount paid unde…

A. The following SSI-related resources are considered in determining eligibility for Medicaid coverage. 1. Annuities a. Any annuity purchases must adhere to the following requirements or the annuity will be considered an available countable resource. i. The annuity must contain a…

A. Only the Office of State Police may enforce the regulations adopted or enacted under this Chapter. B. Any term used in these rules is used in its commonly accepted meaning except where the term has been specifically defined herein or in R.S. 32:1502 or 49 CFR. C. When used in …

A. The following federal hazardous materials regulations promulgated by the U.S. Department of Transportation, revised as of October 1, 1987, and contained the following parts of 49 CFR, as now in effect or as hereafter amended, are made a part of this Chapter. Hazardous Material…

A. For the purposes of this Chapter, the federal regulations, as adopted or amended herein, shall govern all shippers, carriers, drivers, operators, transport vehicles, engines, and trains: 1. to which the federal regulations apply; 2. engaged in the transportation of hazardous m…

A. The logical step, after 1) determining the priority health needs of the state and developing corresponding goals and 2) determining what programs or services are currently in place to meet the needs, is to determine what can be done to meet the unmet need remaining. The follow…

A. To assure that 100 percent of the applications for capital expenditure which are recommended for approval under §1122 are consistent with the criteria and standards in the State Health Plan, including the priority health care goals, in order to assure that unneeded health serv…

A. Development of services at the community level directed toward informing, educating and motivating the public to accept responsibility for protecting their health. 1. Office of Preventive and Public Health Services (OPPHS) a. To motivate industries and groups to initiate healt…

A. This Chapter authorizes federal financial participation in the funding of optional targeted case management service for title XIX eligible infants and toddlers who are ages birth through 2 inclusive (0-35 months) who have a developmental delay or established medical condition …

A. The provider shall ensure that Medicaid-funded family service coordination services for eligible beneficiaries are provided by qualified individuals who meet the following training requirements: 1. satisfactory completion of at least 16 hours of orientation prior to performing…

A. The purpose of this regulation is to provide: 1. tables of select mortality factors and rules for their use; 2. rules concerning a minimum standard for the valuation of plans with nonlevel premiums or benefits; and 3. rules concerning a minimum standard for the valuation of pl…

A. This regulation is promulgated by the commissioner of insurance pursuant to authority granted under the Louisiana Insurance Code, Title 22, Section 22:1 et seq., particularly the Standard Valuation Law, see Title 22, §163.B.1.a and the Standard Nonforfeiture Law for Life Insur…

A. This regulation shall apply to all life insurance policies, with or without nonforfeiture values, issued on or after the effective date of this regulation, subject to the following exceptions and conditions. 1. Exceptions a. This regulation shall not apply to any individual li…

C. Deficiency Reserves for the Secondary Guarantees. Deficiency reserves, if any, for the secondary guarantees shall be calculated for the secondary guarantee period in the same manner as described in §10911.B with gross premiums set equal to the specified premiums, if any, or ot…

A. At the election of the company for any one or more specified plans of life insurance, the minimum mortality standard for basic reserves may be calculated using the 1980 CSO valuation tables with select mortality factors (or any other valuation mortality table adopted by the NA…

A. Basic Reserves. Basic reserves shall be calculated as the greater of the segmented reserves and the unitary reserves. Both the segmented reserves and the unitary reserves for any policy shall use the same valuation mortality table and selection factors. At the option of the in…

A. General 1. Policies with a secondary guarantee include: a. a policy with a guarantee that the policy will remain in force at the original schedule of benefits, subject only to the payment of specified premiums; b. a policy in which the minimum premium at any duration is less t…

A. This appendix contains tables of select mortality factors that are the bases to which the respective percentage of §§10909.A2, 10909.B.2 and 10909.B.3 are applied. B. The six tables of select mortality factors contained herein include: 1. male aggregate; 2. male nonsmoker; 3. …

A. The proposed effective date for this regulation is November 1, 2005.

A. The Deficit Reduction Act of 2005 established new provisions governing the treatment of transfers of assets for individuals and their spouses who apply for or receive long-term care services. B. The look-back period is lengthened to five years for potential transfers of assets…

A. There are basically two types of quality assurance audits required periodically. The systematic audit is required of an agency which collects, maintains and disseminates CHRI as a means of minimizing errors or omissions in the completeness and accuracy of the records. This aud…

A. The systematic audit refers to a combination of systems and procedures employed both to ensure, to the extent possible, completeness and to verify accuracy. The systematic audit is also an internal procedure which basically provides for a comparison between CHRI and source doc…

A. The annual audit will be performed on a random sample of all affected agencies in the state. All affected agencies must fully cooperate in the conduct of the annual audit.

A. LCJIS shall audit, on a periodic basis, a random sampling of agencies to provide statistically significant examinations of the accuracy and completeness of data maintained and to verify adherence to the regulations. Sampling and detailed audit procedures will be as indicated i…

A. The annual audit will be performed by members of the LCJIS staff who are familiar with the agencies and the requirements of the regulations. Agencies to be audited will be given a minimum of 30 days written notice prior to an annual audit being conducted. On conclusion of the …

A. At the time of the audit, the audited agency will have ready to present to the audit team such documentation as may be required by LCJIS, including but not limited to: 1. evidence of procedural compliance including security; 2. copies of systematic audits performed; 3. source …

A. Audited agencies with serious deficiencies as indicated in the formal critique must correct these deficiencies and will render written, corrective action reports to LCJIS monthly until the deficiency is eliminated.

A. The Department of Children and Family Services (DCFS) establishes and will maintain a state repository of all reports of abuse and neglect. The state repository will include information on individuals involved in reports and investigations of child abuse and neglect with the f…

A. Within the state repository of reports of abuse and neglect, the Department of Children and Family Services (DCFS) establishes and maintains a state central registry (SCR) that is comprised of three tier levels of certain justified/valid reports of abuse and neglect. Each just…

A. The Department of Children and Family Services (DCFS) will maintain records of investigations on reports of child abuse and/or neglect in families determined to be not justified/invalid on the State Repository. Except as specifically authorized by law, the records will be main…

A. The Department of Children and Family Services (DCFS) establishes an administrative appeal process with the Division of Administrative Law (DAL). The purpose is to provide individuals the right to appeal DCFS Child Protective Services investigation findings of justified/valid.…

A. The Department of Children and Family Services establishes procedures for implementation of the physician notification, as required by R.S. 40:1086.11. 1. A physician identifying a newborn exhibiting symptoms of withdrawal or other observable and harmful effects in his physica…

A. The following seeds may not be sold, offered for sale, or planted in Louisiana as seed for purposes of producing a new plant, except as otherwise provided by this Chapter. 1. Any portion of any variety of rice that tests positive, according to tolerances established by the dep…

A. Rice seed stocks, where the variety as a whole is found to test positive, according to tolerances established by LDAF, for LL traits may be sold, offered for sale or planted in Louisiana only for the purpose of seed stock increase, subject to the sampling and testing requireme…

A. Samples of all rice seed stocks shall be taken by the Louisiana Department of Agriculture and Forestry (LDAF) for testing. LDAF shall conduct the testing or cause the testing to be done in laboratories approved by LDAF. LDAF shall determine the method and manner of sampling an…

A. All rice seed stocks originating from out-of-state must meet the requirements for sampling, testing, and handling, as established by LDAF.

A. Any carry-over rice seed stocks that have been processed, repackaged, or otherwise adulterated in any manner that would jeopardize the integrity of the seed lot are subject to the sampling and testing requirements set out in this Chapter.