La. Admin. Code tit. 50 § XXI-8701

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

Section XXI-8701 - Plan of Care

A. The applicant and support coordinator have the flexibility to construct a plan of care that serves the participant's health and welfare needs. The service package provided under the POC shall include services covered under the Community Choices Waiver in addition to services covered under the Medicaid state plan (not to exceed the established service limits for either waiver or state plan services) as well as other services, regardless of the funding source for these services. All services approved pursuant to the POC shall be medically necessary and provided in a cost-effective manner. The POC shall be developed using a person-centered process coordinated by the support coordinator.

B. Reimbursement shall not be made for services provided prior to the departments, or its designees, approval of the POC.

C. The support coordinator shall complete a POC which shall contain the:

1. types and number of services (including waiver and all other services) necessary to reasonably assure health and welfare and to maintain the person in the community;

2. individual cost of each waiver service; and

3. total cost of waiver services covered by the POC.

La. Admin. Code tit. 50, § XXI-8701

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 37:3524 (December 2011), amended LR 39:321 (February 2013), 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.