§460.76.1. Medicaid physician reimbursement plan; Medicare rate comparability
A.(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, nonspecialty 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 nonspecialty 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.
Acts 2024, No. 306, §1.