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Wheelchair, Wheelchair Repairs, Standing Frame, and Patient Lift - MEDICAID - LOUISIANA (Revised)
Effective date
Oct 7, 2026
Identified
Oct 15, 2026
Summary
Humana Healthy Horizons Louisiana Medicaid revised its coverage policy for wheelchairs, wheelchair repairs, standing frames, and patient lifts effective 2026-10-07. The policy clarifies prior authorization requirements, medical necessity criteria, required documentation (including state-licensed physician and therapist evaluations), and coverage limitations. Only one wheelchair at a time is covered; backup chairs are denied. All wheelchairs and modifications require prior authorization.
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What to do
Action · 9 steps
01Effective 2026-10-07, the billing team must implement the following changes for Humana Healthy Horizons Louisiana Medicaid members.
02Require prior authorization for ALL wheelchair requests (standard, motorized, and custom motorized) and modifications before claim submission.
03Deny backup wheelchairs (motorized or manual) as not medically necessary.
04Ensure durable medical equipment (DME) requests include complete documentation: physician prescription, Louisiana State Licensed Physician and Physical/Occupational Therapist evaluation form (Standing Frame Evaluation form for standing frames and patient lifts), and original manufacturer price.
05For motorized wheelchairs, verify seating evaluation includes physician signature confirming medical necessity and member's capability to safely operate controls with documented cognitive, motor, and perceptual abilities.
06Restrict wheelchair repairs to basic repairs only (repair of existing components) and require prior authorization for modifications or reconstruction.
07Verify standing frame requests include evidence member has tried cost-effective alternatives, is high-risk for contractures, and has demonstrated improved function or maintained status.
08Update billing workflows and templates to reflect these requirements.
09Billing team should confirm current applicability with Humana and update prior authorization submission protocols immediately to prevent claim denials.
Original notice
Wheelchair, Wheelchair Repairs, Standing Frame, and Patient Lift - MEDICAID - LOUISIANA (Revised)
mcp.humana.com · Always check the source before changing claims.