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Louisiana Medicaid Eligibility Manual Application Processing

Issued January 7, 2026 Replaced July 16, 2024 Page 25 of G-0000 Revised/added text indicated by underscore Deleted text indicated by “**”

Include the applicant's statement regarding the change in medical condition since the denial on the Form MS or MS/C. Give the applicant ten (10) days to provide additional documentation verifying the change in medical condition before submitting the request to the MEDT consultant.

G-1615 RESERVED

G-1620 SIMPLIFIED DISABILITY DECISIONS FOR INFANTS Louisiana Medicaid allows a simplified determination of disability based on minimal evidence for premature or low birth weight infants and/or those infants with an allegation or diagnosis of Down syndrome, even if no other medical impairments exist.

A simplified disability decision for infants always begins on the date of birth and extends until the child reaches the age of one (1) year (date of birth through the 12th month).

Continuing eligibility for Medicaid must be explored whenever there are changes in the child’s circumstances that affect eligibility or once the simplified disability period ends. Another MEDT decision is required for an ongoing disability decision. A review of all current medical evidence must be completed.

G-1620.1 MEDT PACKAGE MEDT will make the simplified disability decision for infants. Submit a MEDT package consisting of a current request for MEDT decision from the MEDT Consultant requesting a simplified disability decision with a birth certificate or other evidence (e.g., the hospital admission summary, physician or other medical professional’s statement) that shows: 1. A weight below 1,200 grams (2 pounds, 10 ounces) at birth; or 2. A gestational age (age from conception to birth) at birth as specified in the bulleted list below with the corresponding birth weight indicated: - If the gestational age is 37- 40 weeks and the weight at birth is less than 2,000 grams (4 pounds, 6 ounces); - If the gestational age is 36 weeks and the weight at birth is less