How to Become a Medicaid Waiver Provider in Louisiana

Louisiana's licensing survey has a requirement that catches nearly every new provider by surprise: you must already be serving a client to be surveyed, and exactly one. After your application packet is accepted and you complete the mandatory HCBS provider training, you have 30 days to admit one client and contact the Health Standards Section field office to schedule the initial survey — and at survey time you must be fully operational, compliant with the standards, and serving only that one client. Miss the 30 days and the application closes; reapplying costs a new fee. The other thing to settle before you start is money you have to show rather than spend: a current $50,000 line of credit from a federally insured lending institution, in the applicant's name, plus at least $300,000 in general and professional liability coverage and current workers' compensation. Personal loans and bank balances do not satisfy the line of credit, and Louisiana grants no waiver of it.

Submit the initial HCBS license packet with the non-refundable fee, complete the mandatory provider training, admit exactly one client and schedule the survey within 30 days, then move on to Medicaid provider enrollment.

1. Assemble the initial license application packet

   Completed HCBS licensure application and the statutory fee; the line of credit, liability, and workers' compensation documentation; the Louisiana State Police background checks for owners and administrators; disclosure of ownership; days and hours of operation; organizational chart; and the facility need review approval letter.

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2. Add the physical-plant approvals if your modules need them

   Adult day care and center-based respite modules require State Fire Marshal architectural plan approval, an on-site State Fire Marshal inspection report with occupancy approval, and an Office of Public Health inspection report with occupancy approval.

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3. Fill any gaps within 90 days

   An incomplete application starts a 90-day window to submit the missing information. Failing to complete it closes the application, and reapplication requires a new licensing fee.

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4. Complete the mandatory HCBS provider training

   After LDH receives a completed packet, you must attend the mandatory provider training or its online alternative. The survey clock starts from there.

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5. Admit one client and schedule the initial survey within 30 days

   Within 30 days of completing training, admit a client and contact the HSS field office to schedule the initial survey. At the survey you must be fully operational, compliant with the standards, and serving only that one client. Missing the deadline closes the application.

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Louisiana does not publish these in a form we could verify, so we have not guessed at them. Ask directly — and if an answer here would help other providers, tell us and we will add it with its source.

• What is the current statutory licensing fee for an initial HCBS license, and for renewal?

  Ask: LDH Health Standards Section, HSS-HC-SC-Licensing@La.Gov

• Does your service type require facility need review approval, and how long does that determination take?

  Ask: LDH Facility Need Review, via the HSS facility need review page

• After licensure, what does Medicaid provider enrollment require for each OCDD waiver you intend to bill, and how long does it take?

  Ask: LDH Medicaid provider enrollment

• What staff training and background screening does the HCBS minimum licensing standard require for direct care workers?

  Ask: LDH Health Standards Section, HSS-HC-SC-Licensing@La.Gov