In 2017, the Louisiana Department of Health and the Department of Public Safety & Corrections collaborated to create a prerelease Medicaid enrollment program. To date, over 17,000 individuals from 18 facilities have applied through the program. This discussion will detail how Louisiana implemented and sustains the program and review CMS guidelines for Medicaid during incarceration, program logistics, staffing roles, system-level requirements, fidelity monitoring, and challenges and opportunities.