MedicaidPrior AuthHigh impact
Home Health - MEDICAID - LOUISIANA (Revised)
Humana·LA · Family Medicine, General Practice, Internal Medicine +3 more·Medicaid
Effective date
Mar 18, 2026
We identified it
Jun 24, 2026
Summary
This policy establishes comprehensive home health service coverage and requirements for Louisiana Medicaid members, including prior authorization requirements for most services, face-to-face encounter documentation, and specific criteria for skilled nursing and home health aide services.
Action Required
Before March 18, 2026: Billing team must implement prior authorization processes for Louisiana Medicaid home health services for adults 21+, extended skilled nursing, multiple daily nursing visits for under-21s, and rehabilitation services. Update systems to require face-to-face encounter documentation within 90 days prior or 30 days after service start. Train staff on Plan of Care requirements and 60-day reauthorization cycles. Claims without proper prior authorization will be denied.