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Regular Session, 2014
SENATE BILL NO. 474
BY SENATOR MILLS
FISCAL CONTROLS. Provides for deficit avoidance procedures for certain Medicaid, other
non-Medicaid health care, and rehabilitation programs. (7/1/14)
AN ACT1
To enact R.S. 39:75(F), relative to the avoidance of deficits; to provide for deficit2
avoidance procedures for certain Medicaid, other non-Medicaid health care, certain elderly3
services, and rehabilitation programs; to provide for an effective date; and to provide for4
related matters.5
Be it enacted by the Legislature of Louisiana:6
Section 1. R.S. 39:75(F) is hereby enacted to read as follows: 7
ยง75. Avoidance of budget deficits8
* * *9
F. Notwithstanding any other provision of this Section to the contrary,10
the following deficit avoidance procedures shall apply to the Medicaid11
programs, non-Medicaid health care, certain elderly services, and rehabilitation12
programs specified herein, as follows:13
(1)(a) In any fiscal year upon receiving notification by the Joint14
Legislative Committee on the Budget that a projected deficit exists, neither the15
governor nor the legislature may reduce Medicaid program rates to provider16
groups below the average Medicaid program rates established for Fiscal Year17 SB NO. 474
SLS 14RS-592 ORIGINAL
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2013-2014, excluding any provider groups that pay fees or assessments that are1
deposited into a special fund that may be established in the Louisiana2
Constitution, to eliminate a budget deficit, except the governor may reduce the3
appropriation for the base rate if the following occur:4
(i) The reduction does not exceed the average reduction of those made5
to the appropriations and reimbursements for other providers under the6
Medicaid program, or its successor; and7
(ii)(aa) If the legislature is in session, the reduction shall receive written8
consent of two-thirds of the elected members of each house in the manner9
provided by law; or10
(bb) If the legislature is not in session, the reduction is approved by a11
favorable vote of two-thirds of the members of the Joint Legislative Committee12
on the Budget, or its successor.13
(b) In any fiscal year upon receiving notification by the Joint Legislative14
Committee on the Budget that a projected deficit exists, neither the governor15
nor the legislature may reduce the budget for any health care agency or facility16
operated under the purview of the Department of Health and Hospitals, or its17
successor, or rehabilitation services operated or managed by the Louisiana18
Workforce Commission, or its successor, or elderly services operated or19
managed by the Governor's Office of Elderly Affairs, or its successor, less than20
the appropriation for any such agencies or facilities in Fiscal Year 2013-2014 to21
eliminate a budget deficit, except the governor may reduce the appropriations22
if the following occur:23
(i) The reductions are proportionally equivalent among all agencies and24
facilities provided for in this Subsection; and25
(ii)(aa) If the legislature is in session, the reduction shall receive written26
consent of two-thirds of the elected members of each house in the manner27
provided by law; or28
(bb) If the legislature is not in session, the reduction is approved by a29 SB NO. 474
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favorable vote of two-thirds of the members of the Joint Legislative Committee1
on the Budget, or its successor.2
(2)(a) The legislature shall annually appropriate the funds necessary to3
provide for Medicaid program rates to provider groups which are no less than4
the average Medicaid program rates established for Fiscal Year 2013-2014,5
excluding those provider groups that pay fees or assessments that are deposited6
into a special fund that may be established in the Louisiana Constitution. The7
Medicaid rates may be adjusted annually by establishing the rates of inflation,8
or rebasing, if applicable. Such inflation rate adjustments shall not be negative.9
If the official forecast of recurring money for the next fiscal year is at least one10
percent less than the official forecast of recurring money for the current fiscal11
year, neither the governor nor the legislature may reduce the base rate as12
provided for in this Subsection to eliminate a budget deficit in the next fiscal13
year, except the governor may reduce the appropriation for the base rate if the14
following occur:15
(i) The reduction does not exceed the average reduction of those made16
to the appropriations and reimbursement for other providers under the17
Medicaid program, or its successor; and18
(ii)(aa) If the legislature is in session, the reductions shall receive written19
consent of two-thirds of the elected members of each house in the manner20
provided by law; or21
(bb) If the legislature is not in session, the reductions are approved by a22
favorable vote of two-thirds of the members of the Joint Legislative Committee23
on the Budget, or its successor.24
(3)(a) The legislature shall annually appropriate the funds necessary to25
provide for Medicaid program rates to provider groups which are no less than26
the average Medicaid program rates established for Fiscal Year 2013-2014,27
excluding any provider groups that pay fees or assessments that are deposited28
into a special fund that may be established in the Louisiana Constitution. The29 SB NO. 474
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Medicaid rates may be adjusted annually by establishing the rates of inflation,1
rebasing, if applicable; as otherwise provided by law. Such inflation rate2
adjustments shall not be negative. If the official forecast of recurring money for3
the next fiscal year is at least one percent less than the official forecast of4
recurring money for the current fiscal year, neither the governor nor the5
legislature may reduce the base rates as provided for in this Subsection to6
eliminate a budget deficit in the next fiscal year, except the governor may7
reduce the appropriation for the base rate if the following occur:8
(i) The reduction does not exceed the average reduction of those made9
to the appropriations and reimbursement for other providers under the10
Medicaid Program, or its successor; and11
(ii)(aa) If the legislature is in session, the reduction shall receive written12
consent of two-thirds of the elected members of each house in the manner13
provided by law; or14
(bb) If the legislature is not in session, the reduction is approved by a15
favorable vote of two-thirds of the members of the Joint Legislative Committee16
on the Budget, or its successor.17
(b) The legislature shall annually appropriate the funds necessary to18
provide funding for any health care agency or facility operated under the19
purview of the Department of Health and Hospitals, or its successor, or20
rehabilitation services operated or managed by the Louisiana Workforce21
Commission, or its successor, or elderly services operated or managed by the22
Governor's Office of Elderly Affairs, that is not less than the appropriation for23
any such agencies or facilities in Fiscal Year 2013-2014. If the official forecast24
of recurring money for the next fiscal year is at least one percent less than the25
official forecast of recurring money for the current fiscal year, neither the26
governor nor the legislature may reduce the budget for any health care agency27
under the purview of the Department of Health and Hospitals, or its successor,28
or rehabilitation services operated or managed by the Louisiana Workforce29 SB NO. 474
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Commission, or its successor, or elderly services operated or managed by the1
Governor's Office of Elderly Affairs, to eliminate a budget deficit in the next2
fiscal year, except the governor may reduce such appropriations if the following3
occur:4
(i) The reductions are proportionally equivalent among all agencies and5
facilities provided for in Subsections A and B of this Section; and6
(ii)(aa) If the legislature is in session, the reductions shall receive written7
consent of two-thirds of the elected members of each house in the manner8
provided by law; or9
(bb) If the legislature is not in session, the reduction is approved by a10
favorable vote of two-thirds of the members of the Joint Legislative Committee11
on the Budget, or its successor.12
(4) For the purposes of this Subsection, "Medicaid Program" shall refer13
to the Louisiana medical assistance program provided for in Title XIX of the14
Social Security Act, or its successor, and "health care agency or facility" shall15
refer to the agencies and facilities that are owned, operated, or managed by the16
Department of Health and Hospitals, or its successor, and shall exclude the17
Medicaid program.18
Section 2. This Act shall become effective on July 1, 2014; if vetoed by the governor19
and subsequently approved by the legislature, this Act shall become effective on July 1,20
2014, or on the day following such approval by the legislature, whichever is later.21
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Jay Lueckel.
DIGEST
Mills (SB 474)
Present law provides for avoidance for budget deficits.
Proposed law provides that notwithstanding any of these provisions, the following deficit
avoidance procedures shall apply to the Medicaid programs, non-Medicaid health care,
certain elderly services, and rehabilitation programs specified herein.
Proposed law provides relative to mid-year adjustments:
(1)(a)For Medicaid programs, in any fiscal year upon receiving notification by the SB NO. 474
SLS 14RS-592 ORIGINAL
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words in boldface type and underscored are additions.
Joint Legislative Committee on the Budget (JLCB) that a projected deficit
exists, neither the governor nor the legislature may reduce Medicaid program
rates to provider groups below the average Medicaid program rates
established for FY 2013-2014, excluding any provider groups that pay fees
or assessments that are deposited into a special fund that may be established
in the Louisiana constitution, to eliminate a budget deficit, except the
governor may reduce the appropriation for the base rate if the following
occur:
(i)The reduction does not exceed the average reduction of those made
to the appropriations and reimbursement for other providers under the
Medicaid program, or its successor.
(ii)The reductions require written consent of two-thirds of the legislature
while in session or two-thirds vote of JLCB when not in session.
(b)For non-Medicaid programs, in any fiscal year upon receiving notification
by JLCB that a projected deficit exists, neither the governor nor the
legislature may reduce the budget for any health care agency or facility
operated under the purview of the Department of Health and Hospitals
(DHH), or its successor, or rehabilitation services operated or managed by
the Louisiana Workforce Commission (LWC), or its successor, or elderly
services operated or managed by the Governor's Office of Elderly Affairs, or
its successor, less than the appropriation for any such agencies or facilities
in FY 2013-2014 to eliminate a budget deficit, except the governor may
reduce the appropriations if the following occur:
(i)The reductions are proportionally equivalent among all agencies and
facilities provided for in proposed law.
(ii)The reductions require written consent of two-thirds of the legislature
while in session or two-thirds vote of JLCB when not in session.
Proposed law provides for ensuing year projected deficits:
(2)(a)For Medicaid programs, the legislature shall annually appropriate the funds
necessary to provide for Medicaid program rates to provider groups which
are no less than the average Medicaid program rates established for FY
2013-2014, excluding those provider groups that pay fees or assessments that
are deposited into a special fund that may be established in the Louisiana
constitution. The Medicaid rates may be adjusted annually by establishing
the rates of inflation, or rebasing, if applicable. Such inflation rate
adjustments shall not be negative. If the official forecast of recurring money
for the next fiscal year is at least one percent less than the official forecast of
recurring money for the current fiscal year, neither the governor nor the
legislature may reduce the base rate as provided for in proposed law to
eliminate a budget deficit in the next fiscal year, except the governor may
reduce the appropriation for the base rate if the following occur:
(i)The reduction does not exceed the average reduction of those made
to the appropriations and reimbursement for other providers under the
Medicaid program, or its successor; and
(ii)The reductions require written consent of two-thirds of the legislature
while in session or two-thirds vote of JLCB when not in session. SB NO. 474
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(3)(a)For non-Medicaid programs, the legislature shall annually
appropriate the funds necessary to provide for Medicaid Program
rates to provider groups which are no less than the average Medicaid
program rates established for FY 2013-2014, excluding any provider
groups that pay fees or assessments that are deposited into a special
fund that may be established in the Louisiana constitution. The
Medicaid rates may be adjusted annually by establishing the rates of
inflation, rebasing, if applicable; as otherwise provided by law. Such
inflation rate adjustments shall not be negative. If the official
forecast of recurring money for the next fiscal year is at least one
percent less than the official forecast of recurring money for the
current fiscal year, neither the governor nor the legislature may
reduce the base rates as provided for in proposed law to eliminate a
budget deficit in the next fiscal year, except the governor may reduce
the appropriation for the base rate if the following occur:
(i)The reduction does not exceed the average reduction of those
made to the appropriations and reimbursement for other
providers under the Medicaid Program, or its successor; and
(ii)The reductions require written consent of two-thirds vote of
the legislature while in session or two-thirds vote of JLCB
when not in session.
(b)For non-Medicaid programs, the legislature shall annually
appropriate the funds necessary to provide funding for any health
care agency or facility operated under the purview of DHH, or its
successor, or rehabilitation services operated or managed by LWC,
or its successor, or elderly services operated or managed by the
Governor's Office of Elderly Affairs, that is not less than the
appropriation for any such agencies or facilities in FY 2013-2014. If
the official forecast of recurring money for the next fiscal year is at
least one percent less than the official forecast of recurring money for
the current fiscal year, neither the governor nor the legislature may
reduce the budget for any health care agency under the purview of
DHH or its successor, or rehabilitation services operated or managed
by LWC, or its successor, or elderly services operated or managed by
the Governor's Office of Elderly Affairs, to eliminate a budget deficit
in the next fiscal year, except the governor may reduce the
appropriations if the following occur:
The reductions require written consent of two-thirds of the legislature while in session or
two-thirds vote of JLCB when not in session.
Proposed law provides that "Medicaid Program" shall refer to the Louisiana medical
assistance program provided for in Title XIX of the Social Security Act, or its successor, and
"health care agency or facility" shall refer to the agencies and facilities that are owned,
operated or managed by DHH, or its successor, and shall exclude the Medicaid Program.
Effective July 1, 2014.
(Adds R.S. 39:75(F))