This bill amends and reenacts specific sections of Louisiana's Medicaid managed care laws, particularly R.S. 46:460.81(B) and (C), while also enacting new provisions under R.S. 46:460.51(18) and 460.81(E). A key addition is the definition of "Coordinated System of Care" (CSoC), which refers to a network of resources aimed at providing access to care for families of children with complex behavioral health needs. The bill establishes an independent claim review process for adverse determinations related to claims filed with managed care organizations, specifically excluding claims filed prior to January 1, 2027, from mandatory arbitration for dispute resolution.

Additionally, the bill clarifies that the Louisiana Department of Health must ensure that independent review entities adhere to standards and criteria established for the CSoC program. It also specifies that adverse determinations not associated with individuals enrolled in the CSoC or Medicaid are ineligible for independent review. The term "managed care organization" is expanded to include any entity contracted with the state to administer the CSoC program, thereby broadening the scope of entities subject to these regulations.

Statutes affected:
HB740 Original: 46:81(C)
HB740 Engrossed: 46:81(C)
HB740 Enrolled: 46:81(B)
HB740 Act 668: 46:81(B)