§450.5. Chronic kidney disease; evaluation; classification; criteria; healthcare coverage

A. Any enrollee in Medicaid who is eligible for services and who has a diagnosis of diabetes or hypertension or who has a family history of kidney disease, shall be evaluated for kidney disease through routine clinical laboratory assessments of kidney function.

B. Any enrollee in Medicaid who is eligible for services and who has been diagnosed with diabetes or hypertension or who has a family history of kidney disease, and who has received a diagnosis of kidney disease shall be classified as a chronic kidney patient.

C. The diagnostic criteria which define chronic kidney disease (CKD) should be generally recognized clinical practice guidelines, which identify chronic kidney disease or its complications based on the presence of kidney damage and level of kidney function.

D. In keeping with the Louisiana Department of Health, Medicaid program's disease management program, patients receiving Medicaid benefits who are at risk for chronic kidney disease will be tracked regarding appropriate diagnostic testing. Medicaid providers will be educated and disease management strategies implemented in order to increase the rate of evaluation and treatment for chronic kidney disease according to accepted practice guidelines including:

(1) Managing risk factors, which prolong kidney function or delay progression to kidney replacement therapy.

(2) Managing risk factors for bone disease and cardiovascular disease associated with chronic kidney disease.

(3) Improving nutritional status of chronic kidney disease patients.

(4) Correcting anemia associated with chronic kidney disease.

Acts 2005, No. 124, §1.