OBJECTIVE: To examine the economic burden of Congestive Heart Failure (CHF) in the Louisiana Medicaid program. STUDY DESIGN: A retrospective review of the medical and pharmacy claims data (years 1999-2000) in the Louisiana Medicaid program. PATIENTS AND METHODS: We reviewed pharmacy and medical claims data for the years 1999-2000 from the Louisiana Medicaid program. The data was obtained from Unisys in a PC compatible format. We extracted the claims for CHF patients on the basis of the ICD-9-CM codes for CHF. A total of 11565 patients met the study criteria, which included diagnostic codes for CHF and continuous eligibility for one year after the initial CHF medical claim. We reviewed all the charges incurred by the patients for the one-year period after their initial medical claim. RESULTS: The total cost for CHF for the one-year period was over $122 million. The CHFdiagnosis related claims formed 13.22 percent of the total cost. Majority of the patients (75 percent) were female and they accounted for 71 percent of the total costs. The mean age of the patients included in this study was 59.9 years and the largest portion of the total costs (56.59 percent) came from the elderly patients group (65 years and older). During the one-year period, 8443 (72.91 percent) of the 11565 CHF patients were hospitalized at a cost of almost $4031 per hospitalized patient. Approximately ten percent of the study population received prescription drugs at an average per patient cost of $174.71. Hospitalizations and prescription drugs contributed 27.73 percent and 0.14 percent respectively to the total costs of CHF. CONCLUSION: CHF represents a significant financial burden from the perspective of the Louisiana Medicaid program. Improved management of the condition is needed to reduce the costs of treatment associated with CHF.