New Louisiana Law Prohibits Medicaid Health Plan Prepayment Reviews

Starting on August 1, 2022, Louisiana’s Medicaid managed care organizations (MCOs) will be prohibited from conducting prepayment reviews of claims submitted by their network provider organizations, unless ordered by the Louisiana Department of Health to conduct such a review. In this context, prepayment review includes any action by the MCO, or any agent acting on behalf of the MCO, to require additional documentation from health care provider organizations prior to claims adjudication.

The new policy is the result of Louisiana Senate Bill 59, which was signed on June 17, 2022. The law was passed to prevent the Louisiana Department . . .