1. A. For recipients enrolled with the CSoC contractor, the department or its fiscal intermediary shall make monthly capitation payments to the CSoC contractor, exclusive of coverage for residential substance use treatment services.

   1. 1. The capitation rates paid to the CSoC contractor shall be actuarially sound rates.

   2. 2. The CSoC contractor will determine the rates paid to its contracted providers.

      1. a. No payments shall be less than the minimum Medicaid rate.

2. B. For recipients enrolled in one of the MCOs, the department or its fiscal intermediary shall make monthly capitation payments to the MCOs inclusive of coverage for the provision of residential substance use services for recipients enrolled in CSoC.

   1. 1. The capitation rates paid to the MCOs shall be actuarially sound rates.

   2. 2. The MCOs will determine the rates paid to its contracted providers.

      1. a. No payment shall be less than the minimum Medicaid rate.

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 38:427 (February 2012), amended by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Behavioral Health, LR 39:3301 (December 2013), LR 41:2358 (November 2015).