October 17, 2014 DHH Submits Revised and Executed Hospital Partnership Agreements to CMS

- This morning, the Louisiana Department of Health (DHH) notified the federal Centers for Medicare and Medicaid Services (CMS) that all parties had signed the revised public-private partnership agreements that now govern the operation of five former LSU hospitals and affiliated clinics across Louisiana. Copies of the agreements were provided to the federal agency as part of LDH's official response to CMS's earlier inquiry. 

Earlier this year, LDH submitted to CMS a revised state plan amendment (SPA) in response to an earlier denial by CMS of pending SPAs that governed payments to the public-private partnerships. LDH worked diligently to craft a new reimbursement methodology that addressed concerns raised by the federal agency.

The revised SPA, transmittal number 14-25, amends Medicaid state plan provisions governing Disproportionate Share Hospital (DSH) payments in order to establish payments to a new category of hospitals, called Louisiana Low-Income Academic Hospitals. On August 19, 2014, CMS provided the state with a request for additional information (RAI), which formally halted the 90-day review clock. In response to questions raised in that RAI, the State has revised its agreements with the partner entities. Specifically, the revised agreements include those with:

  1. Louisiana Children's Medical Center (partner) and University Medical Center Management Corporation (operating subsidiary)
  2. Biomedical Research Foundation of Northwest Louisiana (partner) and BRF Hospital Holdings, L.L.C. (operating subsidiary)
  3. Lafayette General Health System (partner) and University Hospital and Clinics (operating subsidiary)
  4. Our Lady of the Angels Hospital, Inc. (partner)
  5. Southwest Louisiana Hospital Association d/b/a Lake Charles Memorial Hospital (partner)

The revised agreements address concerns raised by CMS regarding funding provisions in the CEAs. Payments to hospital partners will now be governed entirely by the Louisiana Low-Income Academic Hospitals methodology in the Medicaid state plan, rather than funding provisions of the CEA. LDH provided executed copies of the amended agreements to CMS as part of its official response to the August 19, 2014 RAI. This action officially restarts the 90-day review clock, though LDH anticipates a faster decision as the department earlier provided CMS with copies of the amended but unsigned agreements. 

"These changes directly address concerns raised by CMS, and early feedback we havereceived from our federal partners strongly favors a speedy review and approval," said LDH Secretary Kathy Kliebert. "The evidence that these partnerships are improving quality and access to care has never been greater, and we are excited to be moving forward on strong footing into this new era of health care in Louisiana." 

For a copy of the response to CMS, including copies of the revised agreements, click here.

It is clear that the public-private partnerships are transforming the delivery of care to residents by increasing access to primary and specialty care as well as emergency and urgent care. Some of the most recent achievements include:

The Louisiana Department of Health 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 LDH, visit www.dhh.louisiana.gov. For up-to-date health information, news and emergency updates, follow LDH's Twitter account and Facebook.

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Surgeon General Ralph L. Abraham, M.D.

Secretary Bruce D. Greenstein

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