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Managed Care Organization Credentialing for Medical Staff of Hospitals, Federally Qualified Health Centers and Rural Health Clinics (IB 23-18)

Date: 09/18/23

Louisiana Healthcare Connections is sharing with provider credentialing requirements for Medical Staff of Hospitals, Federally Qualified Health Centers, and Rural Health Clinics (IB 23-18) published on September 15, 2023.

Act 143 of the 2022 Regular Legislative Session exempted certain providers from having to satisfy credentialing requirements of Louisiana Medicaid managed care organizations (MCO), including the following: 

  1. Any provider who maintains hospital privileges or is a member of a hospital medical staff with a hospital licensed in accordance with the Hospital Licensing Law, R.S. 40:2100 et seq. 
  2. Any provider who is a member of the medical staff of a Rural Health Clinic (RHC) licensed in accordance with R.S. 40:2197 et seq.
  3. Any provider who is a member of the medical staff of a Federally Qualified Health Center (FQHC) as defined in R.S. 40:1185.3.

If a provider qualifies to credential or re-credential in accordance with Act 143, verification of meeting one of the above three conditions can be submitted to Louisiana Medicaid MCOs at the email addresses below. It is recommended to include “ACT 143” in the subject line. 

 
Aetna Better Health Laprovider@aetna.com
AmeriHealth Caritas LouisianaCredentialing@amerihealthcaritasla.com
Healthy BlueSubmit via Availity portal *If a provider is experiencing trouble with Availty, submit to lainterpr@healthybluela.com 
Humana Healthy HorizonsLAMSProviderIntake@Humana.com
Louisiana Healthcare Connections LHC_Provider_Credent@Centene.com 
United Healthcare Community PlanJoin Our Network | UHCprovider.com,  *If a provider does not have a CAQH number, submit to cred_applications@uhc.com 

  Any providers needing additional assistance from the Louisiana Department of Health can contact providerrelations@la.gov.