Page 21

Louisiana Medicaid Eligibility Manual Application Processing

Issued January 7, 2026 Replaced July 16, 2024 Page 21 of G-0000 Revised/added text indicated by underscore Deleted text indicated by “**”

infected with tuberculosis and is not eligible in a non-MAGI category (formerly category A, B, or D).  A favorable MEDT (or SSA) disability review has expired.

G-1610.3 MEDT DECISION NOT REQUIRED An MEDT decision is not required if:  A favorable SSA decision (or MEDT decision) has been rendered for disability or Medicare which covers the requested period of Medicaid eligibility;  The applicant is otherwise ineligible; or  The applicant has lost RSDI/SSI for a reason other than cessation of disability, and a favorable SSA disability decision has been made within the twelve (12) months prior to application.

G-1610.4 MEDT APPROVAL If the applicant is otherwise eligible. Authorize the case.

If a case has closed and later recertified, the MEDT decision remains in effect, unless there has been improvement in the beneficiary’s condition. Submit a new MEDT packet prior to the MEDT due date if there has been improvement in the beneficiary’s condition.

A subsequent adverse disability decision made by SSA/SSI, that is not timely appealed, takes precedence over the MEDT consultant decision.

Exception: Submit a new MEDT packet for re-evaluation of the agency’s disability determination if a subsequent adverse disability decision by SSA is made for an MPP beneficiary.

G-1610.5 MEDT DENIAL Reject the application or close the case upon receipt of the MEDT denial decision. If applicable, issue an advance notice of closure.