La. Admin. Code tit. 50 § XXI-11529

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

Section XXI-11529 - Professional Services Providers

A. Professional services are direct services to participants, based on need, that may be utilized to increase the participants independence, participation and productivity in the home and community. Service intensity, frequency and duration will be determined by individual need. Professional services include the following:

1. aquatic therapy;

2. art therapy;

3. music therapy;

4. sensory integration; and

5. hippotherapy/therapeutic horseback riding.

B. Professional services must be delivered with the participant present and in accordance with the plan of care.

C. Childrens choice services cannot be provided on the same day at the same time as any other waiver or State Plan service except for the following services:

1. environmental accessibility adaptations;

2. family training;

3. specialized medical equipment and supplies;

4. support coordination; and

5. therapy

D. Childrens choice services cannot be provided in a school setting.

E. Provider Qualifications

1. Individual practitioners must enroll as a Medicaid provider;

2. Have a current, valid license or certification from the appropriate governing board for that profession; and

3. Possess one year of post licensure or certification experience.

a. In addition, the specific service delivered must be consistent with the scope of the license or certification held by the professional.

F. All services rendered shall be prior approved and in accordance with the plan of care.

G . All services must be documented in service notes which describe the services rendered and progress towards the participants personal outcomes and his/her plan of care.

H. Providers of professional services must maintain adequate documentation to support service delivery and compliance with the approved plan of care and provide said documentation upon the LDH's request.

La. Admin. Code tit. 50, § XXI-11529

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office for Citizens with Developmental Disabilities, LR 39:2501 (September 2013), amended LR 41:128 (January 2015), Amended by the Department of Health, Bureau of Health Services Financing and the Office for Citizens with Developmental Disabilities, LR 481544 (6/1/2022).

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