MedicaidCoverageMedium impact
Bariatric Surgery - MEDICAID - LOUISIANA (Revised)
Humana·LA · Bariatric Surgery, General Surgery·Medicaid
Effective date
May 18, 2026
We identified it
Jun 24, 2026
Summary
Humana Louisiana Medicaid has updated their bariatric surgery coverage policy, establishing specific BMI thresholds and comorbidity requirements for adults (BMI ≥40 or ≥35 with comorbidities) and pediatric patients (ages 13-17), along with mandatory multidisciplinary team evaluations. The policy also covers revision surgeries for complications and panniculectomy procedures following bariatric surgery.
Action Required
Before May 18, 2026: Billing team must update prior authorization requirements for bariatric surgery cases to ensure multidisciplinary team evaluations are documented, including physician, nutritionist/dietician, and mental health professional assessments within 12 months of surgery. Update EMR templates to capture BMI thresholds and required comorbidities for different age groups. Verify coverage criteria are met before scheduling surgeries to prevent claim denials.