Case Management Services in Louisiana help individuals enrolled in Medicaid and waiver programs access the care and resources they need to live independently. Case managers work directly with participants, families, providers, and state agencies to assess needs, develop individualized care plans, and coordinate service delivery across health, behavioral, and social domains.

1. GOVERNING AGENCIES

Agency: Louisiana Department of Health (LDH) — Office of Aging and Adult Services (OAAS) & Office for Citizens with Developmental Disabilities (OCDD)
Role: Oversees waiver case management guidelines, assigns support coordination agencies, and ensures compliance with person-centered planning

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight and ensures case management complies with 1915(c) waiver and person-centered service planning requirements

Agency: Medicaid Management Information System (MMIS) / Molina Medicaid Solutions
Role: Manages enrollment and reimbursement for case management billing

Agency: Managed Care Organizations (MCOs) under Bayou Health
Role: Coordinate with case managers for referrals, authorizations, and data reporting (in specific programs)

2. CASE MANAGEMENT SERVICE OVERVIEW

Case Management (also called Support Coordination) is a comprehensive, person-centered service that includes:

• Functional needs assessments and goal setting
• Individualized Service Plan (ISP) or Plan of Care (POC) development
• Referral to home and community-based services (HCBS)
• Coordination with physicians, therapists, and providers
• Monitoring of service delivery and participant satisfaction
• Critical incident reporting and service plan revision
• Advocacy and assistance with transitions (e.g., institutional discharge)

Approved providers support participants in:

• Residential Options Waiver (ROW)
• Supports Waiver
• New Opportunities Waiver (NOW)
• Children’s Choice Waiver
• Community Choices Waiver (limited case management components)
• EPSDT and transition support (for youth aging out of services)

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Louisiana Secretary of State
• Obtain IRS EIN and Type 2 NPI
• Enroll with Medicaid as a Case Management or Support Coordination provider via the Louisiana Medicaid Provider Enrollment Portal
• Apply for waiver-specific designation with LDH (OAAS or OCDD)
• Maintain general liability and professional insurance
• Employ qualified case managers (e.g., social workers, counselors, or human services staff with experience)
• Develop a Case Management Services Policy & Procedure Manual
• Ensure HIPAA-compliant documentation and coordination systems

4. PROVIDER ENROLLMENT PROCESS

Step 1: Business and Medicaid Enrollment

• Apply through https://www.lamedicaid.com
• Submit business documents, staffing plan, and organizational structure

Step 2: Waiver-Specific Approval

• Submit an application to LDH OAAS or OCDD to become an approved support coordination agency
• Complete background checks, staff credentialing, and service protocols

Step 3: Staff Training and Manual Development

• Train staff on person-centered planning, critical incident protocols, and waiver service standards
• Implement care planning and documentation tools

Step 4: Referrals and Service Delivery

• Receive participant assignments from LDH or MCOs
• Begin assessments, service planning, and documentation per waiver rules

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or sole proprietorship filing
• IRS EIN and NPI documentation
• LDH case management designation or waiver program approval
• Certificates of insurance

Case Management Services Policy & Procedure Manual, including:

• Intake and person-centered planning templates
• ISP/POC development forms and service tracking logs
• Referral logs and interdisciplinary team coordination forms
• Critical incident and grievance reporting policies
• Participant rights and informed consent forms
• Monthly monitoring and reassessment schedules
• Documentation, quality assurance, and billing templates

6. STAFFING REQUIREMENTS

Role: Case Manager / Support Coordinator
Requirements: Bachelor’s degree in social work, psychology, or a related field, 1–2 years’ experience with individuals with disabilities or aging adults, background check clearance

Role: Clinical Supervisor (required for agency model)
Requirements: Licensed social worker or mental health professional, responsible for supervision, service review, and compliance

Training Requirements for All Staff:

• HIPAA and participant confidentiality
• Person-Centered Planning and waiver rules
• Abuse/neglect reporting and incident protocols
• Cultural competency and disability rights
• Medicaid billing documentation and audit readiness

7. MEDICAID WAIVER & TRANSITION SERVICES

Case Management Services are authorized and reimbursed under:

• Residential Options Waiver (ROW)
• Supports Waiver
• Children’s Choice Waiver
• New Opportunities Waiver (NOW)
• Community Choices Waiver (limited case management functions)
• EPSDT and Money Follows the Person (MFP) transition supports

Approved providers may deliver:

• In-home assessments and service coordination
• Ongoing case monitoring and documentation
• Plan updates and annual reassessments
• Coordination of transportation, therapy, home modifications, or direct care services
• Transition assistance from institutional care to home/community settings

8. TIMELINE TO LAUNCH

Phase: Business Registration and Staff Hiring
Timeline: 1–2 months

Phase: Medicaid Enrollment and Waiver Approval
Timeline: 60–90 days

Phase: Policy Manual and System Setup
Timeline: 3–4 weeks

Phase: Participant Assignment and Service Delivery
Timeline: Ongoing, based on LDH referrals and waiver enrollment

9. CONTACT INFORMATION

Louisiana Medicaid Provider Enrollment Portal
Website: https://www.lamedicaid.com

​Office of Aging and Adult Services (OAAS)
Website: https://ldh.la.gov/page/119

​Office for Citizens with Developmental Disabilities (OCDD)
Website: https://ldh.la.gov/page/121

​Louisiana Department of Health (LDH)
Website: https://ldh.la.gov

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10. SCOPE OF WORK

• Medicaid enrollment and waiver designation process
• Policy & Procedure Manual development for service coordination
• Intake and care planning templates
• Compliance checklists for documentation, billing, and audit prep
• Staff training logs and credentialing support
• Referral outreach and LDH partnership strategies

Waiver Consulting Group helps qualified professionals and agencies launch Medicaid-approved case management services for Louisiana HCBS waiver participants.

To get started, click the link to request portal access