MedicaidCoverageMedium impact
Quantity Limitation (New)
Humana·LA·Medicaid
We identified it
Jul 2, 2026
Summary
Humana has issued a new Quantity Limitation guidance policy for Medicaid Louisiana members. This policy establishes restrictions on the quantity of services or supplies that can be billed per member within a specified timeframe. The billing team must obtain the full policy details from the source URL to identify which specific services are affected and implement corresponding claim edits.
Action Required
Immediately: Billing team must access the complete policy document at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a56a5a2 to identify specific codes and quantity limits. Once retrieved, update the billing system to enforce quantity limitations for affected services and configure automated denials or holds for claims exceeding limits. Notify providers of new quantity restrictions. Resubmit any recently denied claims if they were rejected due to this new policy. Without implementation, claims for Louisiana Medicaid members may be incorrectly denied or paid.