Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part XXIX - Pharmacy
Chapter 3 - Lock-In Program
Section XXIX-313 - Changing Lock-In Providers
Universal Citation: LA Admin Code XXIX-313
Current through Register Vol. 50, No. 9, September 20, 2024
A. Recipients may change lock-in providers every year without cause. With good cause, they may change lock-in providers only with the bureaus approval. Recipients may change providers for the following "good cause" reasons:
1. a recipient relocates;
2. a recipient's primary diagnosis
changes;
3. the Lock-In provider(s)
request(s) that the recipient be transferred; or
4. the Lock-In provider(s) stop(s)
participating in the Medicaid Program and does not accept Medicaid as
reimbursement for services.
a. The recipient
may still receive other program services available through Medicaid such as
hospital, transportation, etc., which are not controlled or restricted by
placing a recipient in Lock-In for pharmacy and physician services. No
recipient on Lock-In status shall be denied the service of a physician or
pharmacist on an emergency basis within program regulations. In instances in
which a recipient is referred by his Lock-In physician to another enrolled
Medicaid physician who is accepting Medicaid recipients, reimbursement shall be
made to the physician to whom the recipient was referred.
AUTHORITY NOTE: Promulgated in accordance with R.S. 46:153 and Title XIX of the Social Security Act.
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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