SLS 11RS-364 ENGROSSED
Page 1 of 2
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
Regular Session, 2011
SENATE BILL NO. 176
BY SENATORS HEITMEIER AND MILLS
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
HEALTH/HOSPITALS DEPT. Authorizes DHH to develop and maintain an upper payment
limit financing methodology for all health care providers licensed by DHH. (gov sig)
AN ACT1
To enact Part LXX of Chapter 5 of Title 40 of the Louisiana Revised Statutes of 1950, to be2
comprised of R.S. 40:1300.331, relative to Medicaid; to provide for an upper3
payment limit financing mechanism for certain health care providers; to provide for4
rules and regulations; and to provide for related matters.5
Be it enacted by the Legislature of Louisiana:6
Section 1. Part LXX of Chapter 5 of Title 40 of the Louisiana Revised Statutes of7
1950, comprised of R.S. 40:1300.331, is hereby enacted to read as follows:8
PART LXX. HEALTH CARE PROVIDERS UPPER PAYMENT LIMIT9
FINANCING METHODOLOGY10
ยง1300.331. Health care providers; upper payment limit11
A. Subject to appropriation, the Department of Health and Hospitals12
may develop and maintain a Medicaid upper payment limit financing13
methodology which incorporates any health care provider licensed by the14
Department of Health and Hospitals. The purpose of developing an upper15
payment limit financing methodology is to enhance the delivery of health care16
services to the uninsured and Medicaid patients. Any such upper payment limit17 SB NO. 176
SLS 11RS-364 ENGROSSED
Page 2 of 2
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
financing methodology shall be in accordance with federal law and subject to1
approval by the Centers for Medicare and Medicaid Services.2
B. The department may submit waivers or state plan amendments to the3
Centers for Medicare and Medicaid Services in order to secure federal financial4
participation in relation to any such upper payment limit financing5
methodology. Disbursements of monies generated by the use of an upper6
payment limit methodology shall be made only in accordance with an approved7
waiver or state plan amendment.8
Section 2. This Act shall become effective upon signature by the governor or, if not9
signed by the governor, upon expiration of the time for bills to become law without signature10
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If11
vetoed by the governor and subsequently approved by the legislature, this Act shall become12
effective on the day following such approval.13
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Greg Waddell.
DIGEST
Heitmeier (SB 176)
Proposed law provides for the creation and maintenance of a Medicaid upper payment limit
financing methodology which incorporates any health care provider licensed by the
Department of Health and Hospitals.
Proposed law provides that DHH may submit waivers or state plan amendments to CMS in
order to secure federal financial participation in relation to any such upper payment limit
financing methodology. Proposed law further provides that any disbursements of monies
generated by the use of an upper payment limit methodology shall be made only in
accordance with an approved waiver or state plan amendment.
Proposed law provides that proposed law shall be subject to legislative appropriation.
Effective upon signature of the governor or lapse of time for gubernatorial action.
(Adds R.S. 40:1300.331)
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Health and Welfare to
the original bill.
1. Adds the qualification that the provisions of the legislation are subject to
appropriation.