Medicaid State Plan Amendments 2025 | Louisiana Department of Health

Medicaid State Plan Amendments 2025 | Louisiana Department of Health
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Medicaid State Plan Amendments 2025
Medicaid State Plan Amendments 2025
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In compliance with Act 212 of the 2013 Regular Session of the Louisiana Legislature, LDH has made State Plan amendments
(SPA)
available for public view dating back to July 1, 2013. Since the date of implementation, the Department has posted pending SPAs. Some amendments are still pending from prior years, others have been approved since
July 1, 2013
and posted to the site. It should be noted that the SPAs are listed by calendar year as they are created under transmittal numbers indicating the year and chronological order of creation during that year. SPAs approved prior to
July 1, 2013
can be found within the main text of the
comprehensive State Plan
.
25-0001  Personal Care Services - Long Term  *APPROVED*
Initial Submittal
–  June 30, 2025
Public Notice
– September 20, 2024
Tribal Notice
- June 6, 2025
Redlined State Plan Pages – June 30, 2025
Attachment 4.19-B Item 26 Page 1-1a
Attachment 4.19-B Item 26 Page 1b
RAI Letter
- September 25, 2025
RAI Response
- December 1, 2025
CMS Approval
- January 15, 2026
25-0002  Federally Qualified Health Centers Alternative Payment Method  *APPROVED*
Initial Submittal
–  March 6, 2025
Tribal Notice
– January 17, 2025
Public Notice
- February 10, 2025
Redlined State Plan Pages
– March 6, 2025
Response to Standard Funding Questions
– March 6, 2025
CMS Approval
- May 29, 2025
25-0003  CHIP Premium Lock-out Period *APPROVED*
Initial Submittal
–  March 7, 2025
Tribal Notice
– January 28, 2025
Redlined State Plan Pages
– March 7, 2025
CMS Approval
- June 2, 2025
25-0003-A  CHIP Premium Lock-out Period *APPROVED*
Initial Submittal
–  May 6, 2025
Tribal Notice
– January 28, 2025
Redlined State Plan Pages
– May 6, 2025
CMS Approval
- June 2, 2025
25-0004  Medicaid Purchase Plan *APPROVED*
Initial Submittal
–  March 27, 2025
Tribal Notice
– January 17, 2025
Public Notice
- February 20, 2025
CMS Approval
- May 16, 2025
25-0004-A  Medicaid Purchase Plan *APPROVED*
Initial Submittal
–  June 10, 2025
Tribal Notice
– January 17, 2025
Redlined State Plan Pages
- June 10, 2025
Public Notice
- February 20, 2025
CMS Approval
- August 28, 2025
25-0005  Section 5121 Services To Incarcerated Youth *APPROVED*
Initial Submittal
–  March 31, 2025
Tribal Notice
– January 17, 2025
Redlined State Plan Pages – March 31, 2025
SPA Attestation Attachment 3.1 - M, Pages 1-2
TCM Supplement 1 Attachment 3.1 - A, Pages 2-8
Supplement 1 to Attachment 3.1 - A, 2
RAI Letter
- June 25, 2025
RAI Response
- August 4, 2025
CMS Approval
- October 10, 2025
25-0005-A  CHIP Services to Incarcerated Youth *APPROVED*
Initial Submittal
–  June 30, 2025
Tribal Notice
– June 17, 2025
Redlined State Plan Pages
– June 30, 2025
RAI Letter
- August 27, 2025
RAI Response
- February 6, 2026
CMS Approval
- February 6, 2026
25-0005-B  Section 5121 Services To Incarcerated Youth *APPROVED*
Initial Submittal
–  March 31, 2025
Tribal Notice
– January 17, 2025
Public Notice
- June 30, 2025
Redlined State Plan Pages – October 3, 2025
Attachment 4.19-B Item 19 Page 3
Supplement 1 to Attachment 3.1-A Pages 2-8
Response to Standard Funding Questions
– October 3, 2025
CMS Approval
- October 10, 2025
25-0006  ICF/IID Private Temporary Reimbursement Rate   *APPROVED*
Initial Submittal
–  February 25, 2025
Tribal Notice
– February 2, 2025
Public Notice
- January 28, 2025
Redlined State Plan Pages
– February 25, 2025
Response to Standard Funding Questions
– February 25, 2025
CMS Approval
- April 15, 2025
25-0007  ICF/IID Reimbursement Methodology   *APPROVED*
Initial Submittal
–  April 4, 2025
Tribal Notice
– February 20, 2025
Public Notice
- February 20, 2025
Redlined State Plan Pages
– April 4, 2025
Response to Standard Funding Questions
– April 4, 2025
CMS Approval
- June 26, 2025
25-0008  Indian Health Services – Four Walls *APPROVED*
Initial Submittal
–  March 26, 2025
Tribal Notice
– March 18, 2025
CMS Approval
- June 23, 2025
25-0009  Recovery Adult Contractor Program *APPROVED*
Initial Submittal
–  May 22, 2025
Tribal Notice
–  April 1, 2025
Redlined State Plan Pages
– May 22, 2025
CMS Approval
- June 4, 2025
25-0010  Nursing Facilities RUG to PDPM  *APPROVED*
Initial Submittal
–  August 11, 2025
Tribal Notice
– June 30, 2025
Public Notice
- June 30, 2025
Redlined State Plan Pages – August 11, 2025
Attachment 4.19-D Page 1
Attachment 4.19-D Pages 1-1b
Attachment 4.19-D Page 2
Attachment 4.19-D Page 3a
Attachment 4.19-D Pages 4-6
Attachment 4.19-D Pages 9a-9b
Attachment 4.19-D Pages 9n-9q
Response to Standard Funding Questions
– August 11, 2025
CMS Approval
- November 6, 2025
25-0011  Inpatient Hospital Services – Sickle Cell Gene Therapy *APPROVED*
Initial Submittal
–  August 4, 2025
Public Notice
- July 20, 2025
Tribal Notice
– June 30, 2025
Redlined State Plan Pages
– August 4, 2025
Response to Standard Funding Questions
- August 13, 2025
CMS Approval
- October 30, 2025
25-0012  Optional State Supplement   *WITHDRAWN*
Initial Submittal
–  September 29, 2025
Tribal Notice
– August 20, 2025
Redlined State Plan Pages – September 29, 2025
Attachment 2.2-A Page 9c
Attachment 2.2-A Pages 12-13a
Attachment 2.2A Pages 15-18a
Attachment 2.6A Supplement 6
25-0013  Personal Needs Allowance  *APPROVED*
Initial Submittal
–  September 22, 2025
Tribal Notice
– August 20, 2025
Redlined State Plan Pages – September 22, 2025
Attachment 2.6-A Page 4a
Suppliment 12 to Attachment 2.6-A
CMS Approval
- November 3, 2025
25-0014  Targeted Case Management - Ventilator Care Coordination   *APPROVED*
Initial Submittal
–  August 28, 2025
Tribal Notice
– August 22, 2025
Public Notice
- August 22, 2025
Redlined State Plan Pages – August 28, 2025
Supplement 1 to Attachment 3.1A Pages 14-18
Attachment 4.19B Item 19 Page 2
Response to Standard Funding Questions
– August 28, 2025
CMS Approval
- November 20, 2025
25-0015  CHIP Substitution of Coverage *APPROVED*
Initial Submittal
–  June 30, 2025
Tribal Notice
– June 17, 2025
Redlined State Plan Pages
– June 30, 2025
RAI Letter
- August 27, 2025
RAI Response
- April 2, 2026
CMS Approval
- April 20, 2026
25-0015-A  CHIP Substitution of Coverage *APPROVED*
Initial Submittal
–  June 30, 2025
Tribal Notice
– June 17, 2025
Redlined State Plan Pages
– June 30, 2025
RAI Letter
- August 27, 2025
RAI Response
- April 2, 2026
CMS Approval
- April 20, 2026
25-0016  Professional Services Reimbursement Methodology  *APPROVED*
Initial Submittal
–  September 22, 2025
Tribal Notice
– July 3, 2025
Public Notice
- July 2, 2025
Redlined State Plan Pages – September 22, 2025
Attachment 4.19-B Item 5 Pages 2a-2a(2)
Attachment 4.19-B Item 3 Page 3
Attachment 4.19-B Item 6 Pages 2-2a
Attachment 4.19-B Item 13c Page 1
Section 4.19 Page 66(b)
Response to Standard Funding Questions
– September 22, 2025
RAI Letter
- December 11, 2025
RAI Response
- December 23, 2025
CMS Approval
- January 27, 2026
25-0017  Non-Emergency Medical Transportation – Transportation Network Companies  *APPROVED*
Initial Submittal
–  October 1, 2025
Tribal Notice
– August 20, 2025
Public Notice
- August 20, 2025
Redlined State Plan Pages – October 1, 2025
Attachment 3.1-A Item 24a Pages 3-6
Attachment 3.1-D Page 3
Attachment 4.19-B Item 24a Page 2
Response to Standard Funding Questions
– October 1, 2025
CMS Approval
- December 12, 2025
25-0020  Medication-Assisted Treatment (MAT) *APPROVED*
Initial Submittal
–  December 15, 2025
Tribal Notice
– November 20, 2025
Redlined State Plan Pages – December 15, 2025
Attachment 3.1-A Item 13d Pages 11b-11h
Medication Assisted Treatment Preprint
CMS Approval
- January 30, 2026
25-0021  Federally-Facilitated Marketplace Assessments *APPROVED*
Initial Submittal
–  October 31, 2025
Tribal Notice
– October 20, 2025
Public Notice
- October 20, 2025
Redlined State Plan Pages
– October 31, 2025
CMS Approval
- January 27, 2026
25-0022  CHIP- Federally-Facilitated Marketplace Assessments *APPROVED*
Initial Submittal
–  October 31, 2025
Tribal Notice
– October 20, 2025
Public Notice
- October 20, 2025
Redlined State Plan Pages – October 31, 2025
CHIP State Plan Pages
CHIP Eligibility FFM Determinations
CMS Approval
- January 20, 2026
25-0024  Doula Services *APPROVED*
Initial Submittal
–  December 3, 2025
Tribal Notice
– October 20, 2025
Public Notice
- October 20, 2025
Redlined State Plan Pages – December 3, 2025
Attachment 3.1-A Page 13
Attachment 3.1-A Item 13c Page 3
Attachment 4.19-B Item 13c Page 2
CMS Approval
- February 3, 2026
25-0025  Managed Care for Physical and Behavioral Health (Enrollment Broker) *APPROVED*
Initial Submittal
–  December 3, 2025
Tribal Notice
– November 20, 2025
Public Notice
- November 20, 2025
Redlined State Plan Pages
– December 3, 2025
CMS Approval
- December 10, 2025
Surgeon General
Evelyn Griffin, MD
Secretary
Bruce D. Greenstein
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