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Continues the provisions of the January 1, 2017 Emergency Rule which amended the provisions governing the reimbursement methodology for inpatient hospital services to increase the Medicaid reimbursement rate paid to non-rural, non-state hospitals in compliance with the requirements of House Concurrent Resolution (HCR) 51 of the 2016 Regular Session of the Louisiana Legislature.
Repeals the provisions governing the Family Planning Waiver due to the expiration of the §1115 waiver authority on December 31, 2014.
Amends the provisions governing disproportionate share hospital payments in order to make technical revisions to ensure that the provisions governing the qualifying criteria are appropriately formatted in a clear and concise manner in the Louisiana Administrative Code.
Amends the provisions governing the reimbursement methodology for disproportionate share hospital payments to Louisiana low-income academic hospitals in order to revise the reimbursement schedule from annual to quarterly payments.
Repeals and replaces the licensing standards governing ambulatory surgical centers in order to: 1) clarify the existing provisions; 2) provide for inactivation of the provider license in the event of specific qualifying events or circumstances; 3) establish provisions which allow ambulatory surgical centers to enter into use agreements; and 4) ensure consistency with other licensing rules, regulations and processes.
Amends the provisions governing the reimbursement methodology in the Pharmacy Benefits Management Program in order to clarify requirements regarding 340B-covered entities, and to revise the reimbursement methodology to include federal upper limits (FUL), new copayment exemptions and over-the-counter medications added for expansion benefits pursuant to U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) recently released regulations.
Reinstates the Louisiana Health Insurance Premium Payment Program (LaHIPP) in order to reduce Medicaid costs by establishing or maintaining a third party resource as the primary payer of the Medicaid recipient’s medical expenses.
Amends the provisions governing managed care for physical and behavioral health in order to exclude Louisiana Health Insurance Premium Payment Program (LaHIPP) participants from participation in managed care for physical and behavioral health.
Continues the provisions of the August 1, 2015 and July 20, 2016 Emergency Rules which amended the provisions governing the reimbursement methodology for intermediate care facilities for persons with intellectual disabilities (ICFs/ID) in order to adopt provisions to establish supplemental Medicaid payments for services provided to Medicaid recipients residing in privately-owned facilities that enter into a cooperative endeavor agreement with the department and established upper payment limits for supplemental payments to private intermediate care facilities entering into a cooperative endeavor agreement with the department.
Continues the provisions of the April 1, 2015 Emergency Rule which adopted provisions governing long-term personal care services (LT-PCS) which mandated that providers must utilize the electronic visit verification system designated by the department for automated scheduling, time and attendance tracking, and billing for LT-PCS.
Continues the provisions of the January 1, 2017 Emergency Rule which amended the provisions governing the reimbursement methodology for nursing facilities to change the method for nursing facility rate setting from a point-in-time method to a time-weighted method, and to made technical changes to these provisions to incorporate language from the currently approved Medicaid State Plan.
Continues the provisions of the April 7, 2016 Emergency Rule which, in compliance with Act 540 of the 2006 Regular Session of the Louisiana Legislature, amended the provisions governing intermediate care facilities for persons with developmental disabilities to require timely filing of electronic reports related to census information and other needed information during declared disasters or emergencies.