Title 46, Public Welfare and Assistance

0 chapters · 1,238 sections in this title.

1,238 sectionsFiltered byTitle 46

La. Rev. Stat. § 46:453 Repealed by Acts 1997, No
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§453. Repealed by Acts 1997, No. 1155, §3, eff. July 1, 1997.
La. Rev. Stat. § 46:454 Repealed by Acts 1997, No
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§454. Repealed by Acts 1997, No. 1155, §3, eff. July 1, 1997.
La. Rev. Stat. § 46:455 Repealed by Acts 1997, No
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§455. Repealed by Acts 1997, No. 1155, §3, eff. July 1, 1997.
La. Rev. Stat. § 46:456 Repealed by Acts 1997, No
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§456. Repealed by Acts 1997, No. 1155, §3, eff. July 1, 1997.
La. Rev. Stat. § 46:457 Repealed by Acts 1997, No
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§457. Repealed by Acts 1997, No. 1155, §3, eff. July 1, 1997.
La. Rev. Stat. § 46:458 Repealed by Acts 1997, No
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§458. Repealed by Acts 1997, No. 1155, §3, eff. July 1, 1997.
La. Rev. Stat. § 46:459 Repealed by Acts 1997, No
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§459. Repealed by Acts 1997, No. 1155, §3, eff. July 1, 1997.
La. Rev. Stat. § 46:460 Repealed by Acts 1997, No
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§460. Repealed by Acts 1997, No. 1155, §3, eff. July 1, 1997.
La. Rev. Stat. § 46:460.1 1 eff
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§460.1 eff. until Oct. 1, 2027. See Acts 2025, No. 478. §460.1. Submission of quarterly reports to the legislature The Department of Children and Family Services shall submit copies of the federal quarterly ACF-196 and ACF-696 reports to the House and Senate committees on health …
La. Rev. Stat. § 46:460.10 10 eff
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§460.10 eff. until Oct. 1, 2027. See Acts 2025, No. 478. §460.10. Drug testing for certain adult recipients of public assistance; legislative policy; procedures A. The legislature hereby reaffirms the legitimate government function of promoting the safety and welfare of children …
La. Rev. Stat. § 46:460.11 REPEALED BY ACTS 1991, NO
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§460.11. REPEALED BY ACTS 1991, NO. 958, §3 AND ACTS 1991, NO. 1033, §3.
La. Rev. Stat. § 46:460.2 Repealed by Acts 1997, No
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§460.2. Repealed by Acts 1997, No. 1155, §3, eff. July 1, 1997.
La. Rev. Stat. § 46:460.21 Repealed by Acts 2007, No
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§460.21. Repealed by Acts 2007, No. 95, §3, eff. Dec. 31, 2012.
La. Rev. Stat. § 46:460.3 Adult basic education; literacy training; vocational educational training
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§460.3. Adult basic education; literacy training; vocational educational training To the extent allowed by federal law and notwithstanding any other state law, rule, or regulation to the contrary, adult basic education and literacy training shall be included in the definition of …
La. Rev. Stat. § 46:460.31 Definitions
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§460.31. Definitions As used in this Part, the following terms have the meaning ascribed to them in this Section unless the context clearly indicates otherwise: (1) "Department" means the Louisiana Department of Health. (2) "Managed care organization" shall have the same meaning …
La. Rev. Stat. § 46:460.32 Repealed by Acts 2019, No
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§460.32. Repealed by Acts 2019, No. 174, §1, eff. June 11, 2019.
La. Rev. Stat. § 46:460.33 Prior authorization form; requirements
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§460.33. Prior authorization form; requirements A. There shall be a single uniform prescription drug prior authorization form used by all Medicaid managed care organizations, including any Medicaid managed care organization pharmacy benefit managers. The requirement for a single …
La. Rev. Stat. § 46:460.34 Step therapy; fail first protocols; requirements
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§460.34. Step therapy; fail first protocols; requirements A. Each managed care organization that utilizes step therapy or fail first protocols shall comply with the provisions of this Section. B. When medications for the treatment of any medical condition are restricted for use b…
La. Rev. Stat. § 46:460.35 Exemptions
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§460.35. Exemptions The provisions of this Part shall not apply to any entity that contracts with the department to provide fiscal intermediary services in processing claims of health care providers. Acts 2013, No. 312, §1, eff. Jan. 1, 2014.
La. Rev. Stat. § 46:460.36 Pharmacy reimbursement by managed care organizations
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§460.36. Pharmacy reimbursement by managed care organizations A. Words and terms used in this Section shall have the following meanings: (1) "Department" means the Louisiana Department of Health. (2) "Legacy Medicaid rate" means the lesser of one of the following: (a) The publish…
La. Rev. Stat. § 46:460.37 Council on Medicaid Pharmacy Reimbursement; creation; composition, purpose,
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§460.37. Council on Medicaid Pharmacy Reimbursement; creation; composition, purpose, and duties of the council A. There is hereby created within the Louisiana Department of Health the Council on Medicaid Pharmacy Reimbursement, referred to in this Section as the "council". B. The…
La. Rev. Stat. § 46:460.4 Educational opportunities to promote self-sufficiency
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§460.4. Educational opportunities to promote self-sufficiency A. The legislature hereby finds that an employment-focused program has succeeded in reducing public assistance rolls by focusing on the importance of work as a way of escaping poverty; education and employment can give…
La. Rev. Stat. § 46:460.41 Definitions
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§460.41. Definitions As used in this Part, the following terms shall have the meaning ascribed to them in this Section unless the context clearly indicates otherwise: (1) "Department" means the Louisiana Department of Health. (2) "Health care provider" or "provider" means a physi…
La. Rev. Stat. § 46:460.42 Claims payment for care rendered to newborns; reporting
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§460.42. Claims payment for care rendered to newborns; reporting A. Each managed care organization shall compensate, at a minimum, ninety percent of the Medicaid fee-for-service rate in effect for each service coded as a primary care service rendered to a newborn Medicaid benefic…
La. Rev. Stat. § 46:460.5 Earned income disregards for certain TANF recipients
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§460.5. Earned income disregards for certain TANF recipients NOTE: Subsection A eff. until Oct. 1, 2027. See Acts 2025, No. 478. A. In order to promote self-sufficiency, the Department of Children and Family Services shall disregard a recipient's first six months of earnings up t…
La. Rev. Stat. § 46:460.51 Definitions
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§460.51. Definitions As used in this Part, the following terms have the meaning ascribed in this Section unless the context clearly indicates otherwise: (1) "Adverse determination" means any of the following relative to a claim by a provider for payment for a healthcare service r…
La. Rev. Stat. § 46:460.52 Exemptions
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§460.52. Exemptions The provisions of this Part shall not apply to any entity contracted with the Louisiana Department of Health to provide fiscal intermediary services in processing claims of the health care providers. Acts 2013, No. 358, §1, eff. Jan. 1, 2014.
La. Rev. Stat. § 46:460.53 Contract amendments; public notice
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§460.53. Contract amendments; public notice A. The department, prior to executing any amendment to a professional, personal, consulting, or social services contract that provides for managed care under the Louisiana Medical Assistance Program through the use of a managed care org…
La. Rev. Stat. § 46:460.54 Medicaid policies and procedures; procedure for adoption; required content
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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…
La. Rev. Stat. § 46:460.6 Individual development account
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§460.6. Individual development account A. For purposes of this Section, "individual development account" shall mean a financial account to be used for the purposes specified in this Section and established in the name of an individual account holder who is eligible for the indivi…
La. Rev. Stat. § 46:460.61 Provider credentialing
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§460.61. Provider credentialing A. Any managed care organization that requires a healthcare provider to be credentialed, recredentialed, or approved prior to rendering healthcare services to a Medicaid recipient shall complete a credentialing process within sixty days from the da…
La. Rev. Stat. § 46:460.62 Interim credentialing requirements
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§460.62. Interim credentialing requirements A. Under certain circumstances and when the provisions of this Subsection are met, a managed care organization contracting with a group of healthcare providers that bills a managed care organization utilizing a group identification numb…
La. Rev. Stat. § 46:460.63 Physician participation; conditions for termination
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§460.63. Physician participation; conditions for termination A. With respect to credentialing of a physician whose license is in probationary status pursuant to action by the Louisiana State Board of Medical Examiners, no managed care organization shall terminate participation by…
La. Rev. Stat. § 46:460.7 Incentive Award Program; dropout reduction; teen pregnancy reduction
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§460.7. Incentive Award Program; dropout reduction; teen pregnancy reduction NOTE: Subsection A eff. until Oct. 1, 2027. See Acts 2025, No. 478. A. The Department of Children and Family Services in consultation with the Department of Education shall develop and implement a specia…
La. Rev. Stat. § 46:460.70 Timely filing of claims
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§460.70. Timely filing of claims In accordance with the provisions of R.S. 46:442, the department shall not limit the period within which a provider may submit a claim for payment for a covered service rendered to an enrollee to less than three hundred sixty-five days from the da…
La. Rev. Stat. § 46:460.71 Claim payment information
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§460.71. Claim payment information A. Any claim payment to a provider by a managed care organization or by a fiscal agent or intermediary of the managed care organization shall be accompanied by an itemized accounting of the individual services represented on the claim that are i…
La. Rev. Stat. § 46:460.72 Medicaid managed care organization provider notice
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§460.72. Medicaid managed care organization provider notice A. Each Medicaid managed care organization shall comply with the following notice provisions regarding contracted provider status and ability to begin providing services and submitting claims for reimbursement: (1) Any M…
La. Rev. Stat. § 46:460.73 Medicaid managed care organization payment accountability
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§460.73. Medicaid managed care organization payment accountability A.(1) Each Medicaid managed care organization shall be responsible for ensuring that any provider it contracts with or enrolls into its network has attained and satisfies all Medicaid provider enrollment, credenti…
La. Rev. Stat. § 46:460.74 Prior authorization; criteria; notice to providers
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§460.74. Prior authorization; criteria; notice to providers A. The prior authorization requirements of the department and each managed care organization, including prior authorization requirements applicable in the Medicaid pharmacy program, shall either be furnished to the healt…
La. Rev. Stat. § 46:460.75 Provider claim payment and information protection
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§460.75. Provider claim payment and information protection A. If a healthcare provider submits a request, either orally or in writing, to a managed care organization during the time prescribed by state law or regulation in which a managed care organization can subject a claim to …
La. Rev. Stat. § 46:460.76 Prepayment review
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§460.76. Prepayment review A. A managed care organization or a contractor, assignee, agent, or entity acting on the behalf of a managed care organization shall be prohibited from requiring any enrolled provider to be subject to prepayment review unless the requirement is implemen…
La. Rev. Stat. § 46:460.76.1 Medicaid physician reimbursement plan; Medicare rate comparability
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§460.76.1. Medicaid physician reimbursement plan; Medicare rate comparability A.(1) The Louisiana Department of Health shall develop a plan for increased Medicaid managed care organization reimbursement rates and fee-for-service reimbursement rates to physicians at one hundred pe…
La. Rev. Stat. § 46:460.76.2 Medicaid pilot program; portable oxygen concentrator
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§460.76.2. Medicaid pilot program; portable oxygen concentrator A.(1) The legislature finds that Louisiana Medicaid covers portable oxygen concentrators to Medicaid beneficiaries under twenty-one years of age, if deemed medically necessary, through the Early and Periodic Screenin…
La. Rev. Stat. § 46:460.76.3 Claim information; third-party liability
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§460.76.3. Claim information; third-party liability A. The department shall provide all known information about any health insurer or other third party that is legally liable for payment of all or part of a claim for healthcare services furnished under the Medicaid state plan to …
La. Rev. Stat. § 46:460.76.4 Prior authorization; suspension during state of emergency
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§460.76.4. Prior authorization; suspension during state of emergency A. During a state of emergency declared by the governor, the Louisiana Department of Health may suspend utilization management requirements, including but not limited to prior authorization and concurrent review…
La. Rev. Stat. § 46:460.77.1 Behavioral health services claims; limitation on service hours; information
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§460.77.1. Behavioral health services claims; limitation on service hours; information required for payment A.(1) For purposes of this Section, "CPST services" means community psychiatric support and treatment services and "PSR services" means psychosocial rehabilitation services…
La. Rev. Stat. § 46:460.77.2 Behavioral health services claim information; access by legislative auditor and
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§460.77.2. Behavioral health services claim information; access by legislative auditor and Medicaid Fraud Control Unit Upon request of the legislative auditor or the Medicaid Fraud Control Unit of the office of the attorney general, the department shall furnish to the requestor b…
La. Rev. Stat. § 46:460.77.3 Staff training requirements
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§460.77.3. Staff training requirements A. Employees, contractors, and subcontractors of managed care organizations performing work or services related to the performance or supervision of audits, prior authorization determinations, and clinical reviews of mental health rehabilita…
La. Rev. Stat. § 46:460.77.4 Reimbursement for certain behavioral health services
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§460.77.4. Reimbursement for certain behavioral health services A. Subject to approval by the Centers for Medicare and Medicaid Services, the Louisiana Department of Health shall reimburse Medicaid providers for mental health partial hospitalization program services provided at a…
La. Rev. Stat. § 46:460.8 TANF eligibility; teen parent living arrangements; work participation requirements;
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§460.8. TANF eligibility; teen parent living arrangements; work participation requirements; submission of waiver NOTE: Paragraph (A)(1) eff. until Oct. 1, 2027. See Acts 2025, No. 478. A.(1) Any recipient of Temporary Assistance for Needy Families Block Grant (TANF) benefits who …