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Regular Session, 2010
SENATE BILL NO. 806 (Substitute of Senate Bill No. 766 by Senator McPherson)
BY SENATOR MCPHERSON
HEALTH CARE. Provides for a common reimbursement methodology for community
mental health centers and community mental health clinics. (8/15/10)
AN ACT1
To enact Part II of Chapter 58 of Title 46 of the Louisiana Revised Statutes of 1950, to be2
comprised of R.S. 46:2745 and 2746, relative to reimbursement methodology for3
mental health services; to direct the Department of Health and Hospitals to establish4
a common reimbursement methodology for community mental health centers and5
community mental health clinics; to direct the department to promulgate rules and6
regulations relative to the uniform reimbursement methodology; and to provide for7
related matters.8
Be it enacted by the Legislature of Louisiana:9
Section 1. Part II of Chapter 58 of Title 46 of the Louisiana Revised Statutes of10
1950, comprised of R.S. 46:2745 and 2746, is hereby enacted to read as follows:11
PART II. REIMBURSEMENT METHODOLOGY FOR COMMUNITY MENTAL12
HEALTH CENTERS AND COMMUNITY MENTAL HEALTH CLINICS13
§2745. Legislative findings and purpose14
A.(1) The current methodology for reimbursement for services to15
indigent and Medicaid recipients for mental health services results in a16
significant discrepancy between payment rates for community mental health17 SB NO. 806
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centers and community mental health clinics.1
(2) The current methodology has resulted in ready access to mental2
health services for persons covered by Medicare and other health insurance3
programs, while indigent and Medicaid patients are often unable to access4
desperately needed mental health services.5
(3) The Patient Protection and Affordable Care Act, hereinafter referred6
to as the "Act", provides that beginning April 1, 2011, in order to meet the7
definition of a community mental health center, forty percent of the services8
provided by such centers must be provided to non-Medicare recipients.9
Currently, Louisiana's community mental health centers serve a Medicare10
insured clientele that receives approximately ninety percent of their total11
services and generates in excess of eighty-five million dollars for our state's12
economy. If Louisiana's community mental health centers cannot meet the forty13
percent threshold mandated by the Act, that funding could be substantially14
reduced or entirely lost.15
(4) The Act also expands Medicaid eligibility income limits to one16
hundred and thirty-three percent of the federal poverty limit beginning in 2014.17
The Department of Health and Hospitals estimates that may add as many as six18
hundred thousand Louisiana residents to the Medicaid program, meaning that19
almost forty percent of our population will be insured by Medicaid, making it20
virtually impossible for Louisiana-based community mental health centers to21
meet the payor mix threshold mandated by the Act if they are not permitted to22
provide services to our Medicaid population.23
(5) Currently, community mental health centers are certified by the24
Centers for Medicare and Medicaid Services. While Department of Health and25
Hospitals does license mental health clinics, it does not license mental health26
centers. Executive Order BJ 08-24, authorized the department to begin27
accepting applications for enrollment in the Medicaid program from Medicare-28
certified community mental health centers for purposes of adjudicating29 SB NO. 806
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crossover claims from the Medicare program. The executive order also1
provided for the department to begin licensing and accepting applications for2
enrollment in the Medicaid program from new mental health clinics upon3
publication and promulgation of rules and regulations providing for a revised4
reimbursement system and standards of participation for mental health clinics.5
These rules have not yet been published by the Department of Health and6
Hospitals.7
B. The purpose of this Part is to propose changes to the reimbursement8
methodology for community mental health centers and community mental9
health clinics reimbursed through the office of mental health and the Medicaid10
program to ensure that such centers and clinics are paid in accordance with11
R.S. 46:2746.12
§2746. Reimbursement methodology; rules and regulations13
A. The Department of Health and Hospitals shall work with14
stakeholders to develop a common reimbursement methodology for15
freestanding Medicare certified community mental health centers and16
community mental health clinics. Such methodology shall include a17
requirement that all providers be enrolled in the Medicare program and be18
deemed eligible for participation in Medicaid and certified by the Louisiana19
Association for Behavioral Health.20
B. No later than January 1, 2010, the department shall issue a notice of21
intent to promulgate rules and regulations, in accordance with the22
Administrative Procedure Act, to provide for a common reimbursement system.23
Section 2. The Louisiana State Law Institute is hereby directed to place the24
provisions of R.S. 46: 2741 through 2744 in their entirety within Part I of Chapter 58 of Title25
46 of the Louisiana Revised Statutes of 1950, and to designate Chapter 58 as26
"Reimbursement Methodology" and Part I as "Reimbursement Methodology of Nursing27
Homes".28 SB NO. 806
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The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Greg Waddell.
DIGEST
Proposed law provides for legislative findings and purpose.
Proposed law provides that DHH shall work with stakeholders to develop a common
reimbursement methodology for freestanding Medicare certified community mental health
centers and community mental health clinics.
Proposed law provides that such methodology shall include a requirement that all providers
be enrolled in the Medicare program and be deemed eligible for participation in Medicaid
and certified by the Louisiana Association for Behavioral Health.
Proposed law provides that no later than January 1, 2010, the department shall issue a notice
of intent to promulgate rules and regulations, in accordance with the APA, to provide for a
common reimbursement system.
Effective August 15, 2010.
(Adds R.S. 46:2745 - 2746)