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Amends the provisions governing leave of absence days for intermediate care facilities for persons with intellectual disabilities (ICFs/IID) in order to increase the total leave days for ICF/IID clients from 45 to 60 and from 30 consecutive days in any single occurrence to 45 consecutive days.
Amends the provisions governing inpatient hospital services to clarify the purpose of the affiliated agreement that hospitals must have with an accredited institution for major or minor teaching hospital graduation education training and the options applicable for residency programs in order to align the administrative Rule with the current State Plan Amendment approved by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Continues the provisions of the November 09, 2023 Emergency Rule which extended the expiration date for health status monitoring, home delivered meals, activity and sensor monitoring, and personal emergency response systems that were initially added to the Adult Day Health Care waiver as temporary services during the Coronavirus Disease 2019 (COVID-19) public health emergency (PHE) and were extended beyond the May 11, 2023 PHE end date as allowed by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Amends the provisions governing disproportionate share hospital payments to establish the qualification criteria and methodology for payments for the uncompensated care costs of inpatient psychiatric hospitals located in the northern area of the state with an academic training mission for services provided to uninsured and low-income individuals from the payment pool created in accordance with Act 447 of the 2023 Regular Session of the Louisiana Legislature.
Continues the provisions of the October 1, 2023 Emergency Rule, which amended the provisions governing the standards for payment and reimbursement for nursing facilities in order to implement the required transition from the current resource utilization group (RUG-III/RUG-IV) case-mix classification model used under the Medicare skilled nursing facility prospective payment system to the patient driven payment model which was delayed by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services until October 1, 2023 due to the COVID-19 public health emergency and to mandate use of the optional state assessment.
Continues the provisions of the December 1, 2023 Emergency Rule, which amended the provisions in the Medical Transportation Program governing American Rescue Plan Act (ARPA) bonus payments to providers of non-emergency medical transportation (NEMT) services in order to establish the guidelines the department will utilize to oversee the administration and distribution of ARPA bonus payment funds to eligible NEMT providers by the Medicaid managed care organizations.
Continues the provisions of the September 11, 2023 Emergency Rule, which amended the July 1, 2023 Emergency Rule promulgated to comply with the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services requirement that reimbursement for emergency ambulance services transition from the Full Medicaid Pricing program to an approved federal supplemental payment program.
Adopts provisions governing incurred medical and remedial care expenses in the determination of financial eligibility for the Medical Assistance Program in order to deduct expenses incurred for necessary medical and remedial care, subject to the reasonable limits, from the individual’s income when calculating patient liability to an institution and to limit the time institutions have to report these expenses, in compliance with 42 C.F.R. Part 435 Subparts H and I.
Amends the provisions governing nursing recruitment and retention payments in the Home Health Program as a result of the decision by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services to continue to provide funding under the American Rescue Plan Act of 2021 through March 2025.
Amends the provisions governing the Supports Waiver to: 1) add specialized medical equipment and supplies (incontinence supplies) and community life engagement development as services, and transportation as a separate service; 2) add reimbursement for each new service; and 3) allow prevocational services to be delivered virtually in order to align the administrative Rule with the waiver application approved by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Amends the provisions governing the home and community-based behavioral health services waiver in order to clarify the criteria for discharge from the Coordinated System of Care program and ensure that members are aware that their failure to cooperate in the re-evaluation assessment will result in discharge from the waiver program.
Repeals and replaces the provisions of LAC 48:I.Chapter 125 governing facility need review in its entirety in order to re-promulgate these provisions in compliance with Act 531 of the 2022 Regular Session of the Louisiana Legislature and to include requirements for Opioid Treatment Program need and application reviews.