Louisiana Healthcare Connections

Welcome to the Louisiana Healthcare Connections page. The documents below have been designed to help RadMD users navigate the prior authorization process for each program Evolent is responsible for managing. Additional process-specific training tools and modules can be found via links on the Resources tab at the top of the screen.
If you have any questions about our programs, please contact practice success at [email protected]
Program Update: Effective August 1, 2026, select interventional cardiovascular services will require prior authorization, through Evolent, for Louisiana Healthcare Connections Medicaid members 21 years of age and older before being rendered in outpatient or inpatient settings (planned professional services only). The Evolent interventional cardiovascular program will apply to all ordering provider specialties for the following non-emergent elective procedures: Cardiac catheterization and intervention, Electrophysiology, Vascular radiology and intervention, Cardiac surgery, and Vascular surgery.
Advanced Imaging Program
Medicaid Update: Effective 8.1.2026, chronic resynchronization therapy (CRT), implantable cardioverter defibrillator (ICD), pacemaker insertion, and heart catheterization procedures have been moved from the Advanced Imaging (RBM) Utilization Matrix to the Interventional Cardiovascular Program Utilization Matrix. Please refer to the Interventional Cardiovascular Program Utilization Matrix for authorization requirements for these procedures going forward.
- Frequently Asked Questions
- Provider Education Presentation
- Utilization Review Matrix - Medicaid - 2026 (Effective 08.01.2026)
- Utilization Review Matrix - Medicaid - 2026 (Effective 04.01.2026-7.31.2026)
- Utilization Review Matrix - Medicare - 2026
For access to our Advanced Imaging tip sheets/checklists, click here.
Cardiac Program
For access to our Cardiac tip sheets/checklists, click here.
Interventional Cardiovascular Program - Effective August 1, 2026
- Frequently Asked Questions (FAQ) - Medicaid
- Evolent Scope of Service (SOS) - Medicaid
- Utilization Review Matrix - Medicaid
For access to our Cardiac tip sheets/checklists, click here.
To view our interventional cardiovascular training video, click here.
Interventional Pain Management Program
- Frequently Asked Questions
- Provider Education Presentation
- Utilization Review Matrix - Medicaid - 2026
- Utilization Review Matrix - Medicare - 2026
For access to our Interventional Pain Management tip sheets/checklists, click here.
Musculoskeletal Program
- Frequently Asked Questions
- Provider Education Presentation
- Utilization Review Matrix (MSK - Hip, Knee and Shoulder) - 2026
- Utilization Review Matrix (MSK - Spine Surgery) - 2026
For access to our Musculoskeletal tip sheets/checklists, click here.
Peer-to-Peer Process
For access to our peer-to-peer process, click here.
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
Low Dose Chest CT History Form
Clinical Guidelines
- Clinical Guidelines
- Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.

