Page 4

Louisiana Medicaid Eligibility Manual Eligibility Factors

Reissued August 29, 2022

Page 4 of I-1000 Replacing January 21, 2022

Deleted text indicated by “” Revised/added text indicated by underscore

OCDD is responsible for the Level II screening and level of care determination for persons with intellectual disabilities (ID).

Office of Behavioral Health (OBH) is responsible for the Level II screening and level of care determination for persons with the diagnosis mental illness (MI).

I-1020 VERIFICATION

I-1020.1 LTC

The medical certification approval or denial is documented on BHSF Form 142 indicating the effective date and level of care.

The medical certification approval remains valid unless the individual:

• Does not admit to a nursing facility within 30 days of the approval date (the approval date counts as day one),

• Breaks institutional care,

• Has a temporary medical approval, or

• Changes the level of care.

I-1020.2 HCBS

The medical certification approval or denial is documented on the BHSF Form 142, which will indicate the effective date and type of waiver program. The medical certification approval remains valid unless the individual is permanently discharged from waiver.

I-1020.3 CSoC

The medical certification approval process is handled by the CSoC contractor with the CSoC Care Manager conducting the initial screening. After eligibility is established, the Contractor submits which services the child is eligible for, the date span for the waiver and the child’s living setting directly to provider enrollment to add eligibility to the enrollee’s file.