Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part XXIII - Program of All Inclusive Care for the Elderly
Chapter 3 - Services
Section XXIII-305 - Excluded Services
Universal Citation: LA Admin Code XXIII-305
Current through Register Vol. 50, No. 9, September 20, 2024
A. Services excluded from coverage are:
1. any service
that is not authorized by the interdisciplinary team, even if it is a required
service, unless it is an emergency service;
2. private room and private duty nursing
services in an inpatient facility (unless medically necessary), and nonmedical
items for personal convenience such as telephone charges and radio or
television rental (unless specifically authorized by the interdisciplinary team
as part of the participant's plan of care);
3. cosmetic surgery, which does not include
surgery that is required for improved functioning of a malformed part of the
body resulting from an accidental injury or for reconstruction following
mastectomy;
4. experimental
medical, surgical or other health procedures;
5. services furnished outside of the United
States except as follows:
a. in accordance
with
42
CFR 424.122 -
424.124;
or
b. as permitted under the
state's approved Medicaid plan.
AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254, Title XIX of the Social Security Act, and 42 CFR 460 et seq.
Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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