§1259.2. Medicaid coverage for perimenopausal and menopausal care

            A. The Louisiana Medicaid program shall cover inpatient and, if deemed appropriate, outpatient coverage for perimenopausal or menopausal treatment or care when such care or treatment is used for a medically accepted indication and administered in any healthcare facility by any healthcare professional appropriately licensed in this state to provide such medical treatment or care in accordance with state and federal guidelines or certifications.

            B. Any healthcare facility appropriately providing perimenopausal or menopausal treatment or care in accordance with state and federal guidelines or certifications that participates in the Louisiana Medicaid program shall provide perimenopausal or menopausal treatment or care to an individual who is eligible for such enrollment as defined in Subsection C of this Section.

            C.(1) To receive coverage from the Louisiana Medicaid program for perimenopausal or menopausal treatment or care, the eligibility of a prospective enrollee shall be determined by the healthcare facility appropriately providing perimenopausal or menopausal treatment or care in accordance with state and federal guidelines or certifications as provided in Subsection B of this Section.

            (2) A prospective enrollee shall be considered eligible for perimenopausal or menopausal treatment or care enrollment if the individual satisfies all of the following qualifications:

            (a) The individual is enrolled in the Louisiana Medicaid program.

            (b) A licensed healthcare provider has certified that perimenopausal or menopausal treatment or care is medically necessary and appropriate to treat the individual's condition.

            (c) The perimenopausal or menopausal treatment or care is administered in any healthcare facility appropriately providing perimenopausal or menopausal treatment or care in accordance with state and federal guidelines or certifications.

            D. Pursuant to this Section, the secretary of the Louisiana Department of Health shall do all of the following:

            (1) Submit to the Centers for Medicare and Medicaid Services all necessary state plan amendments.

            (2) Promulgate all necessary rules and regulations in accordance with the Administrative Procedure Act.

            (3) Take any other actions necessary to implement the provisions of this Section.

            Acts 2024, No. 784, §2.