Current with changes from the 2024 Legislative Session
Section 46:460.76.1 - Medicaid physician reimbursement plan; Medicare rate comparabilityA.(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 percent of Medicare rates.(2) In developing the plan required by this Section, the department shall prioritize physician-provided primary care, obstetric care, non-specialty mental health, substance use disorder, family planning, and women's health services.(3) The plan shall include Medicaid reimbursement rates for service rates of one hundred percent of the Medicare rate for procedure codes utilized for evaluation and management for primary care and specialty office visits, preventative services, care management, obstetric services, and non-specialty mental health services and the estimated costs of implementation of the plan during Fiscal Year 2025-2026 and increasing incrementally through Fiscal Year 2027-2028.(4) The department shall calculate an equivalent rate increase for physician services that do not have a rate established by Medicare.B. The plan shall include procedure codes identified as physician primary care or general care to be reimbursed to physicians at one hundred percent of Medicare rates.C. The department shall submit the plan required by this Section to the Senate Committee on Health and Welfare, the Senate Committee on Finance, the House Committee on Health and Welfare, and the House Committee on Appropriations no later than November 1, 2024.Added by Acts 2024, No. 306,s. 1, eff. 8/1/2024.