2018-62: LDH Issues Health Plan Advisories for Reimbursement for services for FQHC and RHC Providers

Date: 11/29/18

The Louisiana Department of Health (LDH) has issued two Health Plan Advisories related to Long-Acting Reversible Contraceptives and Screening and Diagnostic Mammographies for FQHC and RHC Providers. Both of the following advisories take effect Jan. 1, 2019:

HPA 18-17:Separate Reimbursement for Long-Acting Reversible Contraceptives in FQHCs and RHCs: This advisory provides notification of a change in the reimbursement methodology for long-acting reversible contraceptives (LARC) to Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC). These providers will be reimbursed separately for the LARC device from the prospective payment system (PPS) rate to reduce barriers and increase access to the LARC device among Louisiana's Medicaid recipients. Effective Jan. 1, 2019, FQHCs and RHCs are eligible for an add-on reimbursement for LARCs. Please click here to review the complete HPA and coverage limitations.

HPA 18-18: Update to Medicaid Policy: Reimbursement for Screening and Diagnostic Mammographies for FQHC and RHC Providers: Effective with dates of service on Jan. 1, 2019, screening and diagnostic mammographies provided on or after Jan. 1, 2019 will be reimbursed at the fee for service rate on file for the Medicaid covered procedure codes at Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC). These rates are on the laboratory and radiology fee schedule at wwww.lamedicaid.com.  Please click here to review the complete HPA and coverage limitations.