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HB740 • 2026

MEDICAID MANAGED CARE: Provides for independent claims review of Coordinated System of Care providers

MEDICAID MANAGED CARE: Provides for independent claims review of Coordinated System of Care providers

Children Healthcare
Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor
Emily Chenevert
Last action
2026-06-03
Official status
Signed by the Governor - Act 668
Effective date
Not listed

Plain English Breakdown

The official source material does not provide specific details on how disputes will be handled for claims after January 1, 2027, if they are not resolved through independent review.

Medicaid Managed Care Independent Claims Review

This act provides for an independent claims review process for providers involved with the Coordinated System of Care (CSoC) program in Medicaid managed care.

What This Bill Does

  • Defines 'Coordinated System of Care' or 'CSoC' as a coordinated network of resources provided by state agencies to help families with children having complex behavioral health needs.
  • Exempts claims filed before January 1, 2027, from independent review if they are related to the CSoC program.
  • Requires an independent review entity to make decisions based on standards and policies outlined in the CSoC contract.
  • Ensures medical necessity determinations for CSoC claims follow approved criteria by the Louisiana Department of Health.

Who It Names or Affects

  • Providers involved with the Coordinated System of Care program
  • Individuals enrolled in Medicaid managed care who are part of the CSoC program

Terms To Know

Coordinated System of Care (CSoC)
A network of resources provided by state agencies to help families with children having complex behavioral health needs.
Managed care organization
An entity that manages Medicaid services and decides which treatments are covered under the program.

Limits and Unknowns

  • The act does not specify what happens to claims filed before January 1, 2027.
  • It is unclear how disputes will be handled for claims after January 1, 2027, if they are not resolved through independent review.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

Filed

Plain English: The amendment changes the definition of Coordinated System of Care, prevents payment disputes from being forced into arbitration starting in January 2027, requires independent reviewers to use official rules and guidelines when deciding disputes, and makes technical adjustments.

  • Changes the definition of 'Coordinated System of Care'.
  • Prevents state-mandated arbitration for Coordinated System of Care payment disputes starting in January 2027.
  • Requires independent review organizations to use official rules and medical guidelines when deciding disputes.
  • The amendment includes technical changes that are not detailed, so their specific impact is unclear.
Adopted

Plain English: The amendment changes the definition of 'Coordinated System of Care' and adds the word 'state' after a specific phrase on page 2.

  • Changes the definition of 'Coordinated System of Care' or 'CSoC' to be a program focused on something (the exact focus is not specified in this amendment).
  • Adds the word 'state' after 'the' on page 2, line 7.
  • The specific focus of the Coordinated System of Care program is not detailed in the provided amendment text.
  • There are no details about what changes or additions will be made to the existing law beyond these two modifications.
Draft

Plain English: The amendment changes the definition of 'Coordinated System of Care' and adds the word 'state' after a specific phrase on page 2.

  • Changes the definition of 'Coordinated System of Care' or 'CSoC' to be a program focused on something (the exact focus is not specified in this amendment).
  • Adds the word 'state' after 'the' on page 2, line 7.
  • The specific focus of the Coordinated System of Care program is not detailed in the provided amendment text.
  • There are no details about what changes or additions will be made to the existing law beyond these two modifications.
Filed

Plain English: The amendment to HB 740 allows for an independent review of claims made by providers in the Coordinated System of Care under Medicaid Managed Care.

  • Adds provisions for an independent claims review process for providers within the Coordinated System of Care.
  • The official amendment text does not provide specific details about how the independent claims review will operate, such as who conducts the reviews or what criteria are used.
Adopted

Plain English: The amendment removes certain lines from an existing Senate committee amendment and changes a reference in the bill text.

  • Removes specific lines from an earlier Senate committee amendment on page 1, lines 17 through 24.
  • Changes 'R.S. 46:460.81(C)' to 'R.S. 46:460.81(B) and (C)' on page 1, line 2.
  • The amendment text does not provide details about the content of the lines being deleted or the full context of the changes made.
Adopted

Plain English: The amendment adds new definitions, provisions, and rules related to independent claims review in the Medicaid Managed Care system for providers involved in the Coordinated System of Care (CSoC) program.

  • Adds specific definitions for 'Coordinated System of Care', 'Family support organization', and 'Statewide management organization'.
  • Specifies that family support organizations providing services under CSoC will continue to operate until a new statewide management organization is selected through a competitive procurement process.
  • Establishes rules regarding independent claims review, including exemptions based on claim filing dates and the prohibition of mandatory arbitration for certain disputes.
  • The amendment text does not provide detailed procedures or timelines for the transition to new statewide management organizations.
Draft

Plain English: The amendment adds a definition for 'Coordinated System of Care' (CSoC) to the bill.

  • Adds a new section defining 'Coordinated System of Care' or 'CSoC', which is described as a network of resources provided by various state departments and offices to help families with children who have complex behavioral health needs.
  • The amendment only provides the definition for CSoC and does not explain how this system will be implemented or what specific services it includes beyond mentioning 'intensive, individualized community based services'.
Draft

Plain English: The amendment adds definitions for 'family support organization' and 'statewide management organization', and ensures that the current family support organization can continue operating until a new statewide management organization is selected through a competitive process.

  • Adds definitions for 'family support organization' and 'statewide management organization'.
  • Ensures the existing family support organization continues to operate without interruption until a new statewide management organization is chosen.
  • The exact details of how the competitive procurement process will be conducted are not specified in this amendment text.
Draft

Plain English: The amendment changes certain references in the bill text, adds exceptions to when claims filed before specific dates will be reviewed independently rather than through arbitration, and specifies that disputes related to the Coordinated System of Care after a certain date must follow independent review procedures.

  • Changes references from 'R.S. 46:460.81(C)' to include both 'B' and 'C'
  • Adds an exception for claims filed before January 1, 2018, which will not be subject to the bill's provisions
  • Specifies that disputes related to the Coordinated System of Care after January 1, 2027, must follow independent review procedures outlined in contracts and statements of work
  • The amendment text does not provide full details on how claims filed before January 1, 2027, under the Coordinated System of Care will be handled after that date.

Bill History

  1. 2026-06-03 H

    Effective date: 08/01/2026.

  2. 2026-06-03 H

    Signed by the Governor. Becomes Act No. 668.

  3. 2026-06-01 H

    Sent to the Governor for executive approval.

  4. 2026-06-01 S

    Signed by the President of the Senate.

  5. 2026-05-31 H

    Enrolled and signed by the Speaker of the House.

  6. 2026-05-29 H

    Read by title, roll called, yeas 97, nays 0, Senate amendments concurred in.

  7. 2026-05-29 H

    Scheduled for concurrence on 05/29/2026.

  8. 2026-05-28 H

    Received from the Senate with amendments.

  9. 2026-05-27 S

    Senate floor amendments read and adopted. Read by title, passed by a vote of 36 yeas and 0 nays, and ordered returned to the House. Motion to reconsider tabled.

  10. 2026-05-27 S

    Called from the Calendar.

  11. 2026-05-21 S

    Read by title and returned to the Calendar, subject to call.

  12. 2026-05-21 S

    Rules suspended.

  13. 2026-05-18 S

    Reported without Legislative Bureau amendments. Read by title and passed to third reading and final passage.

  14. 2026-05-14 S

    Committee amendments read and adopted. Read by title and referred to the Legislative Bureau.

  15. 2026-05-13 S

    Reported with amendments.

  16. 2026-04-15 S

    Read second time by title and referred to the Committee on Health and Welfare.

  17. 2026-04-14 S

    Received in the Senate. Read first time by title and placed on the Calendar for a second reading.

  18. 2026-04-14 H

    Read third time by title, roll called on final passage, yeas 100, nays 0. Finally passed, title adopted, ordered to the Senate.

  19. 2026-04-13 H

    Scheduled for floor debate on 04/14/2026.

  20. 2026-04-09 H

    Read by title, amended, ordered engrossed, passed to 3rd reading.

  21. 2026-04-08 H

    Reported with amendments (10-0).

  22. 2026-03-09 H

    Read by title, under the rules, referred to the Committee on Health and Welfare.

  23. 2026-02-27 H

    First appeared in the Interim Calendar on 2/27/2026.

  24. 2026-02-27 H

    Under the rules, provisionally referred to the Committee on Health and Welfare.

  25. 2026-02-27 H

    Prefiled.

Official Summary Text

MEDICAID MANAGED CARE: Provides for independent claims review of Coordinated System of Care providers

Current Bill Text

Read the full stored bill text 
ENROLLED
ACT No. 6682026 Regular Session
HOUSE BILL NO. 740
BY REPRESENTATIVE CHENEVERT
1 AN ACT
2 To amend and reenact R.S. 46:460.81(B) and (C) and to enact R.S. 46:460.51(18) and
3 460.81(E), relative to Medicaid managed care; to provide for independent claim
4 review process; to provide for definitions; and to provide for related matters.
5 Be it enacted by the Legislature of Louisiana:
6 Section 1. R.S. 46:460.81(B) and (C) are hereby amended and reenacted and R.S.
7 46:460.51(18) and 460.81(E) are hereby enacted to read as follows:
8 §460.51. Definitions
9 As used in this Part, the following terms have the meaning ascribed in this
10 Section unless the context clearly indicates otherwise:
11 * * *
12 (18) "Coordinated System of Care" or "CSoC" means a coordinated network
13 of resources made available through the Louisiana Department of Health,
14 Department of Children and Family Services, state Department of Education, and the
15 office of juvenile justice to create access to care for families of children who have
16 complex behavioral health needs and who are either in or at risk of being in
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are additions.
HB NO. 740 ENROLLED
1 out-of-home placement through development of a care plan that includes intensive,
2 individualized community based services.
3 * * *
4 §460.81. Right of providers to independent review; applicability
5 * * *
6 B.(1) The provisions of this Subpart shall not apply to any adverse
7 determination associated with a claim filed with a managed care organization prior
8 to January 1, 2018, regardless of whether the claim is re-filed after that date. For all
9 adverse determinations related to claims filed on or after January 1, 2018, the state
10 shall not mandate that the provider and managed care organization resolve the claim
11 payment dispute through arbitration.
12 (2)(a) The provisions of this Subpart shall not apply to any adverse
13 determination associated with a claim filed prior to January 1, 2027, to individuals
14 enrolled with an entity contracted with the state to administer the Coordinated
15 System of Care program. In addition, for all adverse determinations related to claims
16 filed on or after January 1, 2027, the state shall not mandate that the provider and
17 entity contracted with the state to administer the Coordinated System of Care
18 program resolve claim payment disputes through arbitration.
19 (b) The Louisiana Department of Health shall ensure that the independent
20 review entity shall make determinations that are consistent with standards, policies,
21 and procedures outlined in the Coordinated System of Care contract and statement
22 of work and that medical necessity determinations are consistent with appropriate
23 medical necessity criteria approved by the department for the Coordinated System
24 of Care program.
25 C. An adverse determination involved in litigation or arbitration or not
26 associated with a Medicaid enrollee an individual enrolled in the Coordinated
27 System of Care or Medicaid shall not be eligible for independent review under the
28 provisions of this Subpart.
29 * * *
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HB NO. 740 ENROLLED
1 E. For purposes of this Subpart, "managed care organization" has the same
2 meaning as set forth in R.S. 46:460.51 and also means any entity contracted with the
3 state to administer the Coordinated System of Care program.
SPEAKER OF THE HOUSE OF REPRESENTATIVES
PRESIDENT OF THE SENATE
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED:
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