La. Admin. Code tit. 50 § XXVII-351
Current through Register Vol. 50, No. 11, November 20, 2024
Section XXVII-351 - Standards for ParticipationA. Rotor winged (helicopters) and fixed winged emergency aircraft must be certified by the Department of Health, Bureau of Health Services Financing in order to receive Medicaid reimbursement. All air ambulance services must be provided in accordance with state laws and regulations governing the administration of these services.B. All air ambulance services must comply with state laws and regulations governing the personnel certifications of the emergency medical technicians, registered nurses, respiratory care technicians, physicians and pilots as administered by the appropriate agency of competent jurisdiction.C. Prior Approval. Prior approval shall not be required for emergency air ambulance transportation services, including mileage. Approval shall be done during post payment review and shall not be completed prior to service delivery. Claims for payment of emergency air ambulance transportation services are received and reviewed retrospectively. The clinical documentation for each emergency air ambulance transportation service shall not be required for submission concurrent with the claim. If required, clinical documentation shall be required post claim submission. 1. Air ambulance claims will be reviewed and a determination will be made based on the following requirements. Air ambulance services are covered only if: a. speedy admission of the beneficiary is essential and the point of pick-up of the beneficiary is inaccessible by a land vehicle; orb. great distance or other obstacles are involved in getting the beneficiary to the nearest hospital with appropriate services.La. Admin. Code tit. 50, § XXVII-351
Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 35:70 (January 2009), Amended by the Department of Health, Bureau of Health Services Financing, LR 49, Amended LR 49(EMERGENCY), Amended by the Department of Health, Bureau of Health Services Financing, LR 50217 (2/1/2024).AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.