La. Admin. Code tit. 50 § XXI-2901

Current through Register Vol. 50, No. 11, November 20, 2024

Section XXI-2901 - Reimbursement and Rate Requirements

A. Adult day health care services shall be reimbursed according to LAC 50:XXI.709.

1. - 5. Repealed.

B. The following services shall be reimbursed at the authorized rate or approved amount of the installation, device/equipment, and when the service has been prior approved by the plan of care:

1. home delivered meals (not to exceed the maximum limit set by OAAS);

2. activity and sensor monitoring;

3. transition services (not to exceed the maximum lifetime limit set by OAAS);

4. personal emergency response system; and

5. assistive technology.

C. ADHC health status monitoring services shall be reimbursed as a per diem rate.

1. - 5.b. Repealed.

D. The following services shall be reimbursed at an established monthly rate:

1. support coordination;

a. - d. Repealed.

2. transition intensive support coordination; and

3. monthly monitoring/maintenance for PERS and/or ASM services.

E. Reimbursement shall not be made for ADHC Waiver services provided prior to the department's approval of the POC and release of prior authorization for the services.

F. The state has the authority to set and change provider rates and/or provide lump sum payments to providers based upon funds allocated by the legislature.

La. Admin. Code tit. 50, § XXI-2901

Promulgated by the Department of Health and Human Resources, Office of Family Security, LR 11:626 (June 1985), amended LR 13:181 (March 1987), amended by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 23:1154 (September 1997), repromulgated LR 30:2041 (September 2004), amended by the Department of Health and Hospitals, Office of the Secretary, Office of Aging and Adult Services, LR 32:2257 (December 2006), LR 34:2164 (October 2008), repromulgated LR 34:2569 (December 2008), amended by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 37:2625 (September 2011), LR 39:2497 (September 2013), Repealed by the Department of Health, Bureau of Health Services Financing, the Office for Citizens with Developmental Disabilities and the Office of Aging and Adult Services, LR 471122 (8/1/2021), Promulgated by the Department of Health, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 482054, Amended LR 495, Amended LR 49683 (4/1/2023), Amended by the Department of Health, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 50395 (3/1/2024).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.