Medicare Medical Policies for
Louisiana and HMO Louisiana, Inc.

Blue Advantage Resources | Providers | Louisiana Blue:

By clicking on "I Accept" below, I acknowledge that I can read and that I have read and accept the following. The Medicare Advantage (MA) Plan must follow all traditional Medicare NCDs and LCDs applicable to the MA Plan’s service area per 42 CFR § 422.101. When coverage criteria are not fully established in traditional Medicare statutes, regulations, NCDs or LCDs (applicable to the MA Plan’s service area), internal coverage criteria can be developed. Internal coverage criteria may be similar or the same as criteria found in LCDs that are applicable outside the MA Plan’s service area, as long as, the criteria are based on current evidence in widely used treatment guidelines or clinical literature and is made publicly available.

The Blue Advantage medical policies below offer clinical guidelines for healthcare providers. These policies are a summary of evidence, list of resources and an explanation of the rationale that supports the adoption of the coverage criteria and are used unless Federal law takes precedence over the policy. Please verify member benefits, limitations and exclusions of coverage before services are rendered.