La. Admin. Code tit. 50 § V-119

Current through Register Vol. 50, No. 11, November 20, 2024

Section V-119 - Coverage of Genetic Testing of Critically Ill Infants

A. Pursuant to Act 501 of the 2022 Regular Session of the Louisiana Legislature, effective for dates of service on or after January 1, 2023, the Medicaid Program shall provide reimbursement to inpatient hospitals for rapid whole genome sequencing testing of a Medicaid enrolled infant who meets all of the following criteria:

1. is one year of age or younger;

2. has a complex illness of unknown etiology; and

3. is receiving inpatient hospital services in an intensive care unit or in a pediatric care unit.

B. For the purposes of this Section, rapid whole genome sequencing testing includes individual sequencing, trio sequencing of the parents of the infant, and ultra-rapid sequencing.

C. Reimbursement. Reimbursement will be made as an add-on service in addition to the hospital payment for the inpatient hospital stay.

La. Admin. Code tit. 50, § V-119

Promulgated by the Department of Health, Bureau of Health Services Financing, LR 49487 (3/1/2023).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.