PART XI. MEDICAID MANAGED CARE PRESCRIPTION DRUG BENEFITS
§460.31. Definitions
As used in this Part, the following terms have the meaning ascribed to them in this
Section unless the context clearly indicates otherwise:
(1) "Department" means the Louisiana Department of Health.
(2) "Managed care organization" shall have the same meaning as provided for that
term in 42 CFR 438.2 and shall also mean any entity providing primary care case
management services to Medicaid recipients pursuant to a contract with the department.
(3) "Medicaid" and "medical assistance program" mean the medical assistance
program provided for in Title XIX of the Social Security Act.
(4) "Prepaid coordinated care network" means a private entity that contracts with the
department to provide Medicaid benefits and services to enrollees of the Medicaid managed
care program in exchange for a monthly prepaid capitated amount per member.
(5) "Primary care case management" means a system in which an entity contracts
with the state to furnish case management services, which include but are not limited to the
location, coordination, and monitoring of primary health care service to Medicaid
beneficiaries.
(6) "Secretary" means the secretary of the Louisiana Department of Health.
Acts 2013, No. 312, §1, eff. Jan. 1, 2014; Acts 2017, No. 349, §2.