DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part of
the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of
the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Kleckley HB No. 532
Abstract: Provides for the legislature to establish a formula for funding hospitals by
establishing reimbursement increases for hospitals; by establishing an assessment on
hospitals; by creating the Hospital Stabilization Fund to deposit assessments; and using
the monies in the fund for reimbursement enhancements.
Proposed constitutional amendment provides for an annual Hospital Stabilization Formula by
concurrent resolution by a favorable vote of 2/3 of the elected members of each house in the first
resolution. The resolution requires a favorable vote of a majority of the elected members of each
house in subsequent years. Further, the resolution shall be referred to the standing committees
of the legislature that hear the general appropriation bill. The formula provided for in the
resolution includes:
(1)A base reimbursement level that is the payment levels under the Medicaid Program to
hospitals for inpatient and outpatient services in FY 2012-2013 in the first year and each
subsequent formula may apply a rate of inflation to the base reimbursement level rate
from the previous fiscal year.
(2)Assessments to be paid by La. hospitals, provided the amount of the assessment does not
exceed the nonfederal share of the reimbursement enhancement.
(3)Reimbursement enhancements for those hospitals subject to an assessment provided for
in the formula.
(4)Any additional provisions necessary to the implementation of the formula. Neither the
assessments nor the reimbursement enhancements established in the formula adopted by
the legislature shall be implemented until each has been approved by the federal authority
which administers the Medicaid Program.
Proposed constitutional amendment provides that the base reimbursement level shall not be paid
from the Hospital Stabilization Fund.
Proposed constitutional amendment provides that no additional assessment shall be collected and
any assessment shall be terminated for the remainder of the fiscal year from the date on which
any of the following occur:
(1)The legislature fails to adopt a formula for the subsequent fiscal year. (2)The Department of Health and Hospitals reduces or does not pay reimbursement
enhancements established in the current formula.
(3)The appropriations provided for in proposed constitutional amendment are reduced.
Proposed constitutional amendment provides that the treasurer shall return any monies collected
after the date of termination of an assessment to the hospital from which it was collected.
Proposed constitutional amendment provides for annual appropriation of an amount necessary to
fund the base reimbursement level for hospitals and appropriate the balance of the Hospital
Stabilization Fund created in the proposed constitutional amendment for reimbursement
enhancements.
Proposed constitutional amendment provides for reductions to the appropriations if the following
occur:
(1)The reduction does not exceed the average reduction of those made to the appropriations
and reimbursement for other providers under the Medicaid Program.
(2)If the legislature is in session, the reduction is consented to in writing by two-thirds of the
elected members of each house in a manner provided by law, or if the legislature is not in
session, the reduction is approved by two-thirds of the members of the Joint Legislative
Committee on the Budget.
Proposed constitutional amendment creates the Hospital Stabilization Fund and provides
appropriations only for funding the reimbursement enhancement established in the Hospital
Stabilization Formula for the fiscal year in which the assessment is collected.
Provides for submission of the proposed amendment to the voters at the statewide election to be
held Nov. 4, 2014, or the first statewide election occurring after the adoption of this Joint
Resolution.
(Adds Const. Art. VII, ยง10.13)
Summary of Amendments Adopted by House
Committee Amendments Proposed by House Committee on Appropriations to the original
bill.
1. Changed the vote necessary for approval of the resolution establishing the formula
from two-thirds of elected members to a majority, except the resolution for the first
formula which shall require a favorable vote of 2/3 of the elected members of each
house.
2. Required the resolution providing for the formula be referred to the standing committees of the legislature that receive the general appropriation bill.
3. Added that the formula provide for the preservation and protection of rural hospitals
as provided for by law.
4. Clarified that rate enhancements established in the formula will be distributed among
hospitals for hospital services and deletes the provision that the rate enhancements
will be distributed in proportion to the Medicaid services delivered.
House Floor Amendments to the reengrossed bill.
1. Clarified that the rate referenced in the proposed constitutional amendment is a
reimbursement.
2. Changed the provisions regarding the rate of inflation used in the formula.
3. Provided that neither the assessments nor the reimbursement enhancements
established in the formula shall be implemented until each has been approved by the
federal authority which administers the Medicaid Program.
4. Changed the provisions required for a reduction in reimbursement level.
5. Changed the provisions regarding the collection and termination of the assessment.
6. Changed the provision regarding the submission of the proposed amendment to the
electors.