DHH Continues to Help Louisiana's Rural Hospitals Serve Medicaid Recipients through an Upper Payment Limit Program

Tuesday, Feb. 14, 2012  |  Contact: Lisa R. Faust; (225) 342-7913 or (225) 252-3579 (cell)

BATON ROUGE - The Louisiana Department of Health and Hospitals is preparing to pay out another $8.9 million to rural hospitals this month to help preserve access to health care for rural communities. The payments are made under an Upper Payment Limit (UPL) Program designed by DHH and championed by State Sen. Francis Thompson and the Louisiana Rural Hospital Coalition.   

"Our rural hospitals play an important role in the state's health care infrastructure," said DHH Secretary Bruce D. Greenstein. "The UPL program is another mechanism to help these critical facilities remain viable and ensure Medicaid recipients and others have access to health care even in our most rural communities. The funding provided through the UPL program will enable substantial investments to help transition as we all work together to address Louisiana's changing health care environment."

In addition to the budget authority provided for the UPL programs in House Bill 1, Gov. Jindal signed Senate Bill 401 of the 2010 regular session by Sen. Thompson to authorize payment to rural hospitals up to the Medicare rate, commonly referred to as the Upper Payment Limit.

"I am thrilled to have partnered with DHH and the Louisiana Rural Hospital Coalition to implement a payment methodology that optimizes Medicaid payments made to rural hospitals," Sen. Thompson said. "These funds will have a tremendous positive impact on the people who count on Medicaid for their health care."

UPL is the difference between the Medicaid rate and the Medicare rate. The federal Centers for Medicare and Medicaid Services (CMS) can authorize a state to pay a provider a supplemental payment to bring them up to the Medicare rate. A UPL payment requires state match to draw down the federal funds and both the state and federal funds are paid to the provider.  DHH submitted a State Plan Amendment to CMS on September 28, 2010 outlining the Rural Hospital UPL plan. CMS granted approval for the inpatient services plan on March 16, 2011 and the outpatient services plan on April 28, 2011.

"Sen. Thompson has long been a passionate advocate for our state's rural hospitals, and I am proud to have had the opportunity to work closely with him," said Louisiana Rural Hospital Coalition Executive Director, Linda Welch. "He was instrumental in crafting the legislation that is helping us improve access to health care for the people of Louisiana who need it most and we couldn't be happier with the outcome."

In State Fiscal Year 2011, DHH paid approximately $37.2 million to rural hospitals through this program, and to date has already paid nearly $18 million in State Fiscal Year 2012. The Rural Hospital UPL is expected to generate more than $35.8 million for rural hospitals by the end of the current fiscal year.

The Louisiana Department of Health and Hospitals strives to protect and promote health statewide and to ensure access to medical, preventive and rehabilitative services for all state citizens. To learn more about DHH, visit http://www.dhh.louisiana.gov. For up-to-date health information, news and emergency updates, follow DHH's blog, Twitter account and Facebook.

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