La. Admin. Code tit. 50 § XXI-8601

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

Section XXI-8601 - General Provisions

A. An organized health care delivery system (OHCDS) is an entity with an identifiable component within its mission to provide services to individuals receiving Community Choices Waiver services. The entity must be a qualified and enrolled Medicaid provider and must directly render at least one service offered in the Community Choices Waiver. As long as the entity furnishes at least one waiver service itself, it may contract with other qualified providers to furnish the other required waiver services.

B. Entities that function as an OHCDS must ensure that subcontracted entities meet all of the applicable provider qualification standards for the services they are rendering.

C. The OHCDS must attest that all applicable provider qualifications are met.

D. Prior to enrollment, an OHCDS must show the ability to provide all of the following Community Choices Waiver services:

1. personal assistance services (PAS);

2. home delivered meals;

3. skilled maintenance therapy;

4. nursing;

5. caregiver temporary support services;

6. assistive devices and medical supplies;

7. environmental accessibility adaptations (EAA); and

8. adult day health care (only if there is a licensed ADHC provider in the service area).

La. Admin. Code tit. 50, § XXI-8601

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 40: 792 (April 2014), Amended LR 412643 (12/1/2015), Amended by the Department of Health, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 441901 (10/1/2018), Amended LR 50787 (6/1/2024).

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