New Enrollment and/or Change of Ownership

Applications for New Enrollments, Reactivations, and Change of Ownership

Hurricane Emergency Expedited Applications

In response to Hurricane Laura, Hurricane Delta, and Hurricane Ida temporary Fee-for-Service emergency enrollments are being approved until the emergency declaration is lifted. Temporary emergency enrollments will not be granted for an effective date prior to 3/1/20 and will be inactivated no later than six (6) months after the emergency declaration has lifted.

This temporary emergency enrollment is for the Fee-for-Service program only. For Healthy Louisiana (Managed Care) contracting and Provider Relations contact information, please visit

Currently Enrolled Providers

Forms to Update Existing Provider Information

Application Fee for Entities/Businesses

The Affordable Care Act requires that some entities/businesses enrolling or reenrolling in Louisiana Medicaid pay a fee to cover the cost of screening. Entities/businesses that are currently enrolled in Medicare or Medicaid in another state are exempt. If your application is received and you are required to pay a fee, you will receive a letter detailing the fee requirement and how to pay. The fee must be received before your application can be approved. This will affect applicable applications received June 1, 2018, or later.

Fingerprint/Background Check Requirements

Notice of Requirement for Fingerprint Based Criminal Background Checks (FCBC) on ‘High’ Risk Medicaid Providers

Quick Facts

Modification of Louisiana Medicaid Provider ID Numbers for New Providers - Click here for more information

Out-of-State Emergency Care

The Louisiana Medicaid Program covers out-of-state emergency services provided to Louisiana Medicaid eligible recipients who are absent from the state when an emergency arises from an accident or illness, when the health of the recipient would be endangered if the recipient undertook travel to return to Louisiana, or when the health of the recipient would be endangered if medical care were postponed until the recipient returns to Louisiana.  For reimbursement, the out-of-state provider must enroll as a Louisiana Medicaid Provider and must follow established timely filing guidelines in submitting claims.


Providers having no billing activity in the last 18 months are subject to autoclosure of their Provider Numbers.

New Address, New Telephone

Timely reporting of a new address and/or new phone number is necessary to avoid closure of your Provider Number.


You are required to provide your NPI in order to process any transaction or correspondence with Provider Enrollment (such as change of address requests, group linkages, direct deposit, and any other correspondence).  Failure to provide your NPI will result in the rejection of your request.

Gainwell Technologies Post Office Boxes