MedicaidPrior AuthMedium impact
Visions of Hope Community Services In Lieu of Service - MEDICAID - LOUISIANA (New)
Humana·LA · Psychiatry, Internal Medicine·Medicaid
Effective date
Oct 7, 2026
We identified it
Oct 15, 2026
Summary
Humana Medicaid (Louisiana) has established a new coverage policy for Visions of Hope Community Services (VOH-CS), an intensive, community-based behavioral health program for high-risk individuals with severe and persistent mental illness. The program bundles individualized supportive treatment, skills training, case management, and social support services. Prior authorization is required for all VOH-CS referrals.
Action Required
Effective 2026-10-07: Billing team must implement prior authorization requirement for Visions of Hope Community Services claims submitted for Louisiana Medicaid (Humana Healthy Horizons) members. Update billing system to flag VOH-CS referrals for prior auth review before claim submission. Providers must verify member eligibility against coverage criteria (age 18+, LOCUS score ≥3, 2+ psychiatric hospitalizations in past year OR 4+ ER behavioral health visits, severe functional impairment, and documented SPMI, substance use disorder, or developmental disability plus 2+ clinical indicators). Bill using HCPCS codes H2022-U1, H2022-U2, or H2022-U3 for the first month of enrollment (based on enrollment date), and H2022 for subsequent months. Verify current applicability of this new policy with Humana and confirm whether the practice is contracted to provide these services in Louisiana.