1. A. The Medicaid Program may reimburse a therapeutic group home for the following services:

   1. 1. screening and assessment services;
   2. 2. therapy services (individual, group, and family whenever possible);
   3. 3. on-going psychiatric assessment and intervention as needed; and
   4. 4. skill-building services.

2. B. Service Exclusions. The following services/components shall be excluded from Medicaid reimbursement:

   1. 1. components that are not provided to, or directed exclusively toward the treatment of, the Medicaid eligible individual;
   2. 2. services provided at a work site which are job tasks oriented and not directly related to the treatment of the recipient’s needs;
   3. 3. any services or components in which the basic nature of which are to supplant housekeeping, homemaking, or basic services for the convenience of an individual receiving services;
   4. 4. services rendered in an institution for mental disease;
   5. 5. room and board; and
   6. 6. supervision associated with the child’s stay in the TGH.

Authority Note

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

Historical Note

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 38:428 (February 2012), amended by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Behavioral Health, LR 41:2371 (November 2015), amended by the Department of Health, Bureau of Health Services Financing and the Office of Behavioral Health, LR 44:1904 (October 2018).