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Regular Session, 2013
HOUSE BILL NO. 533
BY REPRESENTATIVES KLECKLEY AND LEGER
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
FUNDS/FUNDING: (Constitutional Amendment) Creates the Medical Assistance Trust
Fund as a constitutional fund, creates accounts for each provider paying fees into the
fund, and provides for uses of the fund
A JOINT RESOLUTION1
Proposing to add Article VII, Section 10.13 of the Constitution of Louisiana, to provide2
relative to health care funding; to create the Louisiana Medical Assistance Trust3
Fund as a treasury fund; to provide for accounts within the Louisiana Medical4
Assistance Trust Fund; to provide for deposit, use, and investment of the fund; to5
provide for a base rate for certain Medicaid Program provider funding; to provide for6
submission of the proposed amendment to the electors; and to provide for related7
matters.8
Section 1. Be it resolved by the Legislature of Louisiana, two-thirds of the members9
elected to each house concurring, that there shall be submitted to the electors of the state of10
Louisiana, for their approval or rejection in the manner provided by law, a proposal to add11
Article VII, Section 10.13 of the Constitution of Louisiana, to read as follows:12
§10.13. Louisiana Medical Assistance Trust Fund13
(A) There is hereby established as a special fund in the state treasury the14
Louisiana Medical Assistance Trust Fund, hereinafter referred to as "the fund",15
which shall consist of monies generated by fees as provided for in law. Subject to16
the exceptions contained in Article VII, Section (9)(A) of this constitution, and after17
compliance with the requirements of Article VII, Section 9(B) of this constitution18
relative to the Bond Security and Redemption Fund, the treasurer shall deposit all19 HLS 13RS-926 ENGROSSED
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proceeds from the fees collected as provided for in laws relative to the Medical1
Assistance Trust Fund into the fund. The monies in the fund shall be invested by the2
state treasurer in the same manner as monies in the state general fund. All interest3
earned from the investment of monies in the fund shall be deposited in and remain4
to the credit of the fund. All unexpended and unencumbered monies remaining in5
the fund at the close of each fiscal year shall remain in the fund.6
(B) The treasurer is hereby authorized to establish a separate account within7
the fund for each health care provider group in which fees are collected according8
to law. Monies collected from each provider group, and the interest earned on those9
monies, shall be deposited into the account created for that provider group. Any10
monies deposited into the fund from sources not required by law, and the interest11
earned on those monies, shall be deposited into a separate account within the fund,12
hereafter referred to as "the general account".13
(C) The legislature is authorized to appropriate monies from the fund only14
if the appropriation is eligible for federal financial participation under Title XIX of15
the Social Security Act, or its successor. The balance of each account shall be16
appropriated for reimbursement of services to the provider group which paid the fee17
into the account in any fiscal year, except monies deposited into the general account18
may be appropriated for any Medicaid Program expenditure.19
(D) The monies appropriated from the provider accounts in the fund shall not20
be used to displace, replace, or supplant appropriations from the state general fund21
for the Medicaid Program below the amount of state general fund appropriations to22
the Medicaid Program for Fiscal Year 2013-2014.23
(E)(1) The legislature shall annually appropriate the funds necessary to24
provide for Medicaid Program rates for each provider group which pays fees into the25
fund that is no less than the average Medicaid Program rates established for Fiscal26
Year 2013-2014 and adjusted annually by establishing the rates of inflation, which27
rates shall not be negative, to be applied to the base rates to establish the new base28
rates for the next fiscal year as authorized by law. For the purpose of this Section,29 HLS 13RS-926 ENGROSSED
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"Medicaid Program" shall refer to the Louisiana medical assistance program1
provided for in Title XIX of the Social Security Act, or its successor.2
(2) Notwithstanding Article VII, Section 10(F) of this constitution, neither3
the governor nor the legislature may reduce the base rate as provided for in this4
Paragraph to satisfy a budget deficit, except the governor may reduce the5
appropriation for the base rate if the following occur:6
(a) Such reduction is consented to in writing by two-thirds of the elected7
members of each house in a manner provided by law; and8
(b) Such reduction does not exceed the average reduction of those made to9
the appropriations for other providers under the Medicaid Program.10
Section 2. Be it further resolved that this proposed amendment shall be submitted11
to the electors of the state of Louisiana at the statewide election to be held on November 4,12
2014.13
Section 3. Be it further resolved that on the official ballot to be used at the election,14
there shall be printed a proposition, upon which the electors of the state shall be permitted15
to vote YES or NO, to amend the Constitution of Louisiana, which proposition shall read as16
follows:17
Do you support an amendment to authorize the legislature to create the18
Louisiana Medical Assistance Trust Fund, for the payment of Medicaid19
reimbursement to the health care provider groups paying fees into the fund?20
(Adds Article VII, Section 10.13)21
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. 533
Abstract: Creates the La. Medical Assistance Trust Fund as a constitutional fund;
establishes accounts within the fund to deposit provider fees; uses the accounts to
provide reimbursement for Medicaid services; and establishes a Medicaid base rate
of reimbursement for certain provider groups.
Present law (R.S. 46:2623 and 2625 and R.S. 22:842) creates the La. Medical Assistance
Trust Fund (MATF) and appropriates monies in the fund for use and expenditure under the HLS 13RS-926 ENGROSSED
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supervision of the secretary of the Dept. of Health and Hospitals for the Medicaid program.
The fees collected are from nursing facilities, intermediate care facilities for people with
developmental disabilities, prescriptions, medical transportation providers, and health care
premium assessments paid by Medicaid-enrolled managed care organizations.
Proposed constitutional amendment creates the La. MATF as a constitutional fund and
provides for the deposit of all proceeds from the fees collected as provided for in present law
into the fund. Proposed constitutional amendment establishes separate accounts within the
fund for each health care provider group in which fees are collected according to law and
deposits the monies collected from each provider group into the account created for that
provider group. Any monies deposited into the fund from sources not required by law are
deposited into a general account.
The balance of each account can be appropriated for reimbursement of services to the
provider group which paid the fee into the account in any fiscal year, except monies
deposited into the general account may be appropriated for any Medicaid Program
expenditure.
Proposed constitutional amendment requires the legislature to annually appropriate the funds
necessary to provide for Medicaid Program rates for each provider group which pays fees
into the fund that is no less than the average Medicaid Program rates established for FY
2013-2014 and adjusted annually by establishing the rates of inflation, which rates shall not
be negative, to be applied to the base rates to establish the new base rates for the next fiscal
year as authorized by law.
Proposed constitutional amendment further provides for reductions to the base rate if the
reduction is consented to in writing by 2/3 of the elected members of each house in a manner
provided by law and does not exceed the average reduction of those made to the
appropriations for other providers under the Medicaid Program.
Provides for submission of the proposed amendment to the voters at the statewide election
to be held Nov. 4, 2014.
(Adds Const. Art. VII, §10.13)
Summary of Amendments Adopted by House
Committee Amendments Proposed by House Committee on Appropriations to the
original bill.
1. Deleted provision regarding partial appropriation from the accounts in the fund
in Fiscal Years 2013-2014 and 2014-2015.
2. Clarified that a base Medicaid rate is to be annually appropriated for the provider
groups paying fees into the fund and no longer specifies the appropriation from
the fund is the base rate.
3. Changed the provision regarding the authority for reduction from a reduction of
appropriation from the fund to a reduction of appropriation of the base rate.