La. Admin. Code tit. 50 § XXII-6501

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

Section XXII-6501 - Covered Services

A. The coverage of OUD/SUD residential treatment and withdrawal management services during residential stays under the scope of this demonstration project are:

1. inpatient services provided to recipients in IMDs;

2. residential treatment provided to recipients in IMDs;

3. clinically managed withdrawal management provided to recipients in IMDs;

4. medically monitored/managed withdrawal management provided to recipients in IMDs; and

5. medication-assisted treatment (MAT) provided to recipients in IMDs.

B. A licensed mental health practitioner (LMHP) or physician who is acting within the scope of his/her professional license and applicable state law shall determine the medical necessity of all OUD/SUD services furnished under this waiver.

1. For the purposes of this Chapter, the term medically necessary means that the services provided under this waiver are reasonably calculated by an LMHP or a physician:

a. to reduce the disability resulting from the illness; and

b. to restore the recipient to his/her best possible functioning level in the community.

La. Admin. Code tit. 50, § XXII-6501

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 38:821 (March 2012), Repealed LR 42754 (5/1/2016), Promulgated by the Louisiana Department of Health, Bureau of Health Services Financing and the Office of Behavioral Health, LR 45272 (2/1/2019).

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