Behavioral health

Coverage for Humana Healthy Horizons^® in Louisiana members includes mental health and substance use disorder services. We strive to ensure our child and adult members access and get effective treatment. We work closely with the Louisiana Department of Health (LDH) and you to make sure our:

Administrative processes are easy to understand and follow
Members get the care and services they need as soon as they recognize the need
Members get all medically necessary services, focused on measurable outcomes that support recovery

Louisiana Crisis Response System

Your patients in crisis can call 988, the Suicide and Crisis Lifeline. Confidential support is available 24/7.

Learn more about 988

The LDH Office of Behavioral Health (OBH) has in place a Medicaid service delivery system related to crisis services, including:

Mobile crisis response
Behavioral health crisis centers
Community brief crisis support
Crisis stabilization

Learn more about the Louisiana Crisis Response System and 988 Lifeline

Description of behavioral health services

We include below a summary of behavioral health services our members can access. For additional information, please refer to the Louisiana Behavioral Health Services Provider Manual that LDH maintains and makes available online.

Service

Service description

Addiction services

These services include an array of individual-centered outpatient, intensive outpatient, and residential services consistent with the individual’s assessed treatment needs, with a rehabilitation and recovery focus designed to promote skills for coping with and managing substance use symptoms and behaviors.

Assertive community treatment

Treatment includes interventions that address the functional problems of individuals who have the most complex and/or pervasive conditions associated with a serious mental illness or co-occurring addictions disorder. These interventions are strength-based and focus on promoting symptom stability, increasing the individual’s ability to cope and relate to others, and enhancing the highest level of functioning in the community.

Community psychiatric support and treatment

Treatment includes goal-directed support and solution-focused interventions intended to achieve identified goals or objectives as set forth in the individualized treatment plan.

Crisis intervention

Methods are used to offer immediate, short-term help to individuals who experience an event that produces emotional, mental, physical, and/or behavioral distress or problems.

Electroconvulsive therapy

Standard psychiatric treatment is provided in which seizures are electrically induced to provide relief from psychiatric illnesses.

Family psychotherapy

Family members can talk with a behavioral healthcare professional about emotional problems they may be having and learn coping skills the family can use to manage them.

Functional family therapy

This is an evidence-based program (EBP) for youth between the ages of 10 and 18 who primarily demonstrate externalizing behaviors or are at risk for developing more severe behaviors, which affect family functioning.

Group psychotherapy

A group of people with similar emotional issues meet with a behavioral healthcare professional. Group members share experiences, practice coping skills, and learn how to manage issues as independently as possible.

HOMEBUILDERS^®

This is an intensive, in-home EBP utilizing research-based strategies (e.g., motivational interviewing, cognitive and behavioral interventions, relapse prevention, skills training) for families with children (age 17 and under) at imminent risk of out-of-home placement (requires a person with placement authority to state that the child is at risk for out-of-home placement without HOMEBUILDERS) or being reunified from placement. Homebuilders is provided through the Institute for Family Development.

Individual psychotherapy

Individuals can talk with a behavioral healthcare professional about emotional issues they may be having and learn coping skills to manage them.

Inpatient/Hospital-based care

This involves the need for one or more nights in a hospital for emergency treatment that cannot otherwise be treated in the community by a provider.

Multisystemic therapy^®

Multisystemic therapy (MST) is an EBP that provides intensive home/family and community-based treatment for youth who are at risk of out-of-home placement or who are returning from out-of-home placement.

Outpatient therapy

This includes individual, family, and group psychotherapy and mental health assessment, evaluation, and testing.

Peer support

This is provided by a peer support specialist (who received behavioral health services themselves) to help individuals learn to manage difficulties in their lives. Peer support services are a covered benefit when performed by local governing entities.

Pharmacologic management

Individuals meet with a physician or other prescriber to discuss medications.

Covered services

The following covered services are available to our members:

23-hour observation
Assertive community treatment (for members 18 and older)
Community psychiatric support and treatment
Crisis intervention (initial visit per diem)
Crisis intervention follow-up
Crisis stabilization
Evaluation and assessment
Functional family therapy (for members under age 21)
HOMEBUILDERS (for members under age 21)
Inpatient hospitalization
Multisystemic therapy (for members under age 21)
Neuropsychological testing
Outpatient electroconvulsive therapy
Outpatient psychotherapy (individual, group, family)
Outpatient substance abuse services
Peer support services
Pharmacologic management
Psychiatric residential treatment facility (for members under age 21)
Psychological testing
Psychosocial rehabilitation
Residential substance use services in accordance with the American Society of Addiction Medicine (ASAM) levels of care
Substance abuse intensive outpatient program
Therapeutic group home (for members under age 21)

Clinical practice guidelines

Behavioral health guidelines are evidence-based treatment options for common behavioral health conditions. Derived from credible sources and reviewed semiannually by Humana psychiatrists who support the treatment options, these guidelines are a means to standardize treatment with the most effective interventions available.

Review Humana’s behavioral health guidelines

Behavioral health documents and forms

These documents apply to all counties where Humana Healthy Horizons coverage is available.

Behavioral Health Applied Behavioral Health Authorization , PDF

Behavioral Health Community-Based Outpatient Services Request Form, PDF

Behavioral Health Concurrent Review for Inpatient and Partial Hospitalization Program , PDF

Behavioral Health Crisis Services Treatment Request Form , PDF

Behavioral Health Individual Placement and Support Request Form , PDF

Behavioral Health Initial Review for Inpatient and Partial Hospitalization Program , PDF

Behavioral Health Neuropsychological Testing Request Form, PDF

Behavioral Health Peer Support Request Form , PDF

Behavioral Health Personal Care Services Request Form , PDF

Behavioral Health Psychiatric Residential Treatment Facilities Authorization Form , PDF

Behavioral Health Psychological Testing Authorization Form , PDF

Behavioral Health Substance Abuse Services Request Form , PDF

Physical health documents and forms

These documents apply to all parishes where Humana Healthy Horizons coverage is available.

Physical Health Authorization Request Form , PDF

Physical Health Outpatient Therapy Authorization Request Form , PDF

Trainings

The LDH OBH makes available standardized basic training modules for unlicensed providers and direct care staff as an introduction to the key concepts they must be familiar with and competencies they must demonstrate prior to rendering specialized behavioral health services to Medicaid recipients in Louisiana. After completing each training, an attestation must be submitted to us.

Behavioral health standardized basic training modules for unlicensed providers

OBH provides approved statewide trainings for peer support specialists and makes every effort to ensure a minimum of 10 trainings are offered each year. Trainings may be conducted virtually or in person at various locations around the state. Capacity for the trainings is limited; therefore, the application process is competitive. Upon successful completion of training, peer support specialists will be deemed recognized by the state of Louisiana.

Peer support training information