SLS 10RS-871 ENGROSSED
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
Regular Session, 2010
SENATE BILL NO. 235
BY SENATOR HEITMEIER
HEALTH CARE. Provides for a physician Medicaid upper payment limit methodology.
(gov sig)
AN ACT1
To enact Chapter 64 of Title 46 of the Louisiana Revised Statutes of 1950, to be comprised2
of R.S. 46:2891, relative to Medicaid upper payment limit collaboratives; to provide3
for a Medicaid physician upper payment limit methodology to continue access to4
healthcare services; to provide for development of funding mechanisms for hospitals;5
and to provide for related matters.6
Be it enacted by the Legislature of Louisiana:7
Section 1. Chapter 64 of Title 46 of the Louisiana Revised Statutes of 1950,8
comprised of R.S. 46:2891, is hereby enacted to read as follows:9
CHAPTER 64. PHYSICIAN UPPER PAYMENT LIMIT METHODOLOGY10
ยง2891. Physician upper payment limit methodology11
The Department of Health and Hospitals is hereby authorized to develop12
mechanisms to support the continued operation of state-funded health care13
programs, specifically Medicaid, through the utilization of physician upper14
payment limit reimbursement methodologies. The methodology utilized shall15
be designed to continue access and delivery of healthcare services to the poor.16
The implementation of this methodology is subject to federal law and approval17 SB NO. 235
SLS 10RS-871 ENGROSSED
Page 2 of 2
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
of the Centers for Medicare and Medicaid Services. Participation in the1
utilization of physician upper payment limit reimbursement methodologies shall2
be limited to only those hospitals which certify public expenditures to the state3
of Louisiana.4
Section 2. This Act shall become effective upon signature by the governor or, if not5
signed by the governor, upon expiration of the time for bills to become law without signature6
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If7
vetoed by the governor and subsequently approved by the legislature, this Act shall become8
effective on the day following such approval.9
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Greg Waddell.
DIGEST
Heitmeier (SB 235)
Proposed law authorizes DHH to develop mechanisms to support the continued operation
of state-funded health care programs, specifically Medicaid, through the utilization of
physician upper payment limit reimbursement methodologies.
Proposed law provides that the methodology utilized shall be designed to continue access
and delivery of healthcare services to the poor.
Proposed law provides that implementation of this methodology is subject to federal law and
approval of the CMS.
Proposed law provides that participation in the utilization of physician upper payment limit
reimbursement methodologies shall be limited to only those hospitals which certify public
expenditures to the state of Louisiana.
Effective upon signature of the governor or lapse of time for gubernatorial action.
(Adds R.S. 46:2891)
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Health and Welfare to
the original bill.
1. Changes the type of upper payment limit authorized from a public/private
upper payment limit to a physician upper payment limit.
2. Limits participation in the physician upper payment limit to those hospitals
which make certified public expenditures to the state.
2. Technical amendments.