Page 17

Louisiana Medicaid Eligibility Manual Application Processing

Issued January 7, 2026 Replaced July 16, 2024 Page 17 of G-0000 Revised/added text indicated by underscore Deleted text indicated by “**”

cooperate. Refer to G-1130 LTC Refusal to Cooperate.

Before denying or closing eligibility for failure to cooperate, review the case record to determine the following:  That the applicant/beneficiary/responsible person is physically, mentally, or intellectually able to meet responsibilities;  That adequate time was given to provide the information or evidence;  That the applicant/beneficiary was given enough notice to make arrangements to provide the information requested or has made contact asking for a specified future date to provide;  That the request for information was clear, in writing, and dated;  That the applicant/beneficiary/responsible person was informed of the responsibility for providing and consequences of not providing information; and  That the applicant/beneficiary is not claiming good cause for failure to cooperate in pursuing a responsible third party. Refer to I-200 Assignment of Rights.

G-1150 SECOND CONTACT SITUATIONS Second contacts are required in the following situations:

A patient in an acute care hospital is given ten (10) calendar days to provide requested information. If the information is not provided, a final notice is sent to the applicant with an additional ten (10) calendar days given to supply the requested information.

If the agency representative is unable to judge the applicant's capability, contact the applicant or responsible person prior to rejecting the application for:  Failure to cooperate in supplying requested data;  Refusal to comply with agency regulations; or  Failure to keep an appointment without contacting to reschedule. After the second contact, if the applicant or responsible person fails to comply with the above, reject the application effective the day following the date of noncompliance, ** or 60 days from the application date,