LDH to launch program for children with disabilities to receive Medicaid

Louisiana News

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BATON ROUGE, La. (BRPROUD) — The Louisiana Department of Health (LDH) has announced the approval of a program allowing children under 19 years old with disabilities to receive Medicaid coverage regardless of parent income.

According to LDH, the Centers for Medicaid and Medicaid Services (CMS) approved Louisiana Medicaid to launch Act 421 Children’s Medicaid Option, also known as TEFRA. The program will be effective January 1, 2022.

LDH said qualifications for the program include:

  • Children must have a disability recognized under the definition utilized in the Supplemental Security Income program of the Social Security Administration
  • Meet basic Medicaid and institutional level-of-care requirements
  • Care must cost less at home than in an institution

“In our work each day within the Louisiana Department of Health, our goal is to help individuals receive care in a safe setting of their choice. We are grateful for both of our legislators and to CMS for approval to offer an option allowing children to remain in their homes to receive care that will help them thrive,” said LDH Secretary Dr. Courtney N. Phillips.

“This is a great day for families with children with disabilities in Louisiana,” said Rep. Dodie Horton. “TEFRA will allow these children to avoid long stays in hospitals and get the care they need while living at home in the comfort of their family and friends.”

“We are excited about this new program and the significant impact it will have on our working families and children with disabilities to help make their lives easier while providing much-needed services,” said Rep. Dustin Miller. “Thanks to all of our stakeholders and other community partners for working with us to help move this forward.”

“Good health insurance often only covers a small portion of what children with disabilities need. This puts working families in a terrible predicament. Families can’t quit their jobs to get help. And they can’t help their kids without jobs,” said Ashley McReynolds, Parent and Program Director at The ARC of Louisiana. “TEFRA will be such a huge help in assisting families with the extraordinary cost of raising a child with a disability.”

The state health department says applications for the program can be submitted starting January 1, 2022, and applicants must complete the following four steps:

  1.  Medicaid Application
  2. Level of Care Assessment at your Local Governing Entity
  3. Disability Determination
  4. Enrollment/Service Coverage through a Healthy Louisiana plan

For more information visit www.ldh.la.gov/act421.

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