HLS 15RS-1588 REENGROSSED
2015 Regular Session
HOUSE CONCURRENT RESOL UTION NO. 75
BY REPRESENTATIVES KLECKLEY, ADAMS, ARMES, ARNOLD, BADON,
BARROW, BILLIOT, WESLEY BISHOP, BOUIE, BROWN, BURRELL,
EDWARDS, GAINES, GISCLAIR, GUILLORY, HALL, HILL, HOWARD,
HUNTER, JACKSON, JAMES, JEFFERSON, JONES, TERRY LANDRY, LEBAS,
LEGER, MONTOUCET, NORTON, PIERRE, PRICE, REYNOLDS, SCHRODER,
SHADOIN, SMITH, ST. GERMAIN, ALFRED WILLIAMS, PATRICK
WILLIAMS, WILLMOTT, AND WOODRUFF
HOSPITALS: Provides for a hospital stabilization formula
1 A CONCURRENT RESOL UTION
2To provide for a hospital stabilization formula pursuant to Article VII, Section 10.13 of the
3 Constitution of Louisiana; to establish the level and basis of hospital assessments;
4 to establish certain reimbursement enhancements for inpatient and outpatient hospital
5 services; to establish certain criteria for the implementation of the formula; to
6 establish the base reimbursement level paid to hospitals; to provide for related
7 matters.
8 WHEREAS, through the adoption of this Resolution, the Legislature of Louisiana
9hereby seeks to:
10 (1)Preserve and enhance the availability of inpatient and outpatient hospital
11 services for the citizens of Louisiana.
12 (2)Preserve and protect rural hospitals as provided in the Rural Hospital
13 Preservation Act, pursuant to R.S. 40:1300.141 et seq.
14 (3)Enhance the stability of hospital funding by utilizing a healthcare driven
15 solution which provides a reliable and recurring source of funding for
16 healthcare services.
17 (4)Minimize the effects of shifting the cost of caring for those Louisiana
18 citizens who are uninsured to those who are able to obtain health insurance.
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1 (5)Create flexibility to design a plan to provide for more efficient and effective
2 ways to maximize the state's use of monies currently expended for the
3 provision of health care services to the state's low income and uninsured
4 residents.
5 THEREFORE, BE IT RESOLVED that the Legislature of Louisiana does hereby
6enact the following hospital stabilization formula pursuant to Article VII, Section 10.13 of
7the Constitution of Louisiana:
8 I. Hospital Stabilization Assessment.
9 A. The Department of Health and Hospitals shall calculate, levy, and collect
10 an assessment for each assessed hospital in accordance with Subsection B of this
11 Section if all of the following occur:
12 (1) Implementation of the reimbursement enhancements as provided for in
13 Paragraph (1) of Section II of this Resolution on or before April 1, 2016.
14 (2) The applicable federal financial participation, as set forth in 42 U.S.C.
15 1396d(y) of Title XIX of the Social Security Act, is less than one hundred percent.
16 (3) Approval from the Joint Legislative Committee on the Budget of the
17 proposed assessment, including a list of each hospital that will be assessed.
18 B.(1) The total assessment for the state fiscal year shall be equal to, but shall
19 not exceed, the lesser of the following:
20 (a) The state portion of the cost, excluding any federal financial
21 participation, of the reimbursement enhancements provided for in Paragraph (1) of
22 Section II of this Resolution which are directly attributable to payments to hospitals.
23 (b) One percent of the total net patient revenue of all hospitals included in
24 the assessment, as reported in the Medicare cost report ending in federal fiscal year
25 2013.
26 (2) The Department of Health and Hospitals shall allocate the assessment to
27 each assessed hospital on a pro rata basis by calculating the quotient of the total
28 assessment divided by the total net patient revenue of all assessed hospitals as
29 reported in the Medicare cost report ending in federal fiscal year 2013 and
30 multiplying the quotient by each assessed hospital's total net patient revenue. If a
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1 hospital was not required to file a Medicare cost report or did not file a Medicare
2 cost report ending in federal fiscal year 2013, the hospital shall submit to the
3 Department of Health and Hospitals its most applicable fiscal year total of net patient
4 revenue in a form prescribed by the department.
5 (3) The Department of Health and Hospitals shall levy and collect the
6 assessment provided for in this Section on a quarterly basis. Prior to levying or
7 collecting the assessment for the applicable quarterly period, the Department of
8 Health and Hospitals shall publish in the Louisiana Register the total amount of the
9 quarterly assessment and the corresponding applicable percentage of total net patient
10 revenue that will be applied to the assessed hospitals.
11 C.(1) The Department of Health and Hospitals shall exclude a hospital from
12 the assessment if any of the following are applicable:
13 (a) The hospital is certified by Medicare as a separately licensed long-term
14 acute care, rehabilitation, or psychiatric hospital.
15 (b) The hospital has sixty or less beds, either as reported in the Medicare cost
16 report ending in federal fiscal year 2013 or as licensed by the Department of Health
17 and Hospitals on December 31, 2013.
18 (c) The hospital meets the definition of a rural hospital as defined in R.S.
19 40:1300.143.
20 (2) The Department of Health and Hospitals may also exclude a hospital or
21 class of hospitals which is necessary to achieve approval of the assessment from the
22 Centers for Medicare and Medicaid Services.
23 II. Reimbursement Enhancements.
24 The Department of Health and Hospitals shall provide for reimbursement
25 enhancements as follows:
26 (1) Payment for health care services through the implementation of a health
27 coverage expansion of the Louisiana medical assistance program that meets all the
28 requirements necessary for the state to maximize federal matching funds as set forth
29 in 42 U.S.C. 1396d(y) of Title XIX of the Social Security Act.
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1 (2) Payment of either the hospital inpatient and outpatient reimbursement
2 rates which were in effect on December 31, 2010, or such rates which were in effect
3 on June 30, 2013, whichever is greater, for hospital services provided pursuant to the
4 Louisiana medical assistance program provided that there are adequate savings
5 generated from the implementation of a health coverage expansion as provided for
6 in this Section and funds are appropriated in the budget.
7 III. Hospital Base Reimbursement Level.
8 The hospital base reimbursement level is hereby defined and established as
9 all inpatient and outpatient hospital reimbursement rates and methodologies under
10 the state plan for the Louisiana medical assistance program, including, but not
11 limited to inpatient peer group per diem rates, outpatient fee schedules, outpatient
12 cost reimbursed services and cost report settlements, supplemental, outlier, and other
13 special payments, including Medicaid Disproportionate Share Hospital payments,
14 and all other polices and methodologies related to claims administration,
15 reimbursement, and adjudications adopted by the Department of Health and
16 Hospitals in effect on June 30, 2013, except for the following amendments to the
17 state plan for the Louisiana medical assistance program:
18 (1) Any amendment approved by the Centers for Medicare and Medicaid
19 Services after June 30, 2013, regardless of the effective date of the amendment.
20 (2) Amendments identified by the following transmittal numbers:
21 (a) TN 09-55.
22 (b) TN 09-56.
23 (c) TN 10-26.
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)]
HCR 75 Reengrossed 2015 Regular Session Kleckley
Provides for a hospital stabilization formula pursuant to Art. VII, Sec. 10.13 of the
Constitution of La. including an assessment, reimbursement enhancements, and a base
reimbursement level.
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Provides for DHH to calculate, collect, and levy as an assessment from hospitals equal to the
lesser of one of the following:
(1) The state portion of the cost, excluding any federal financial participation, of the
reimbursement enhancements from the payment for health care services through the
implementation of Medicaid expansion which are directly attributable to payments
to hospitals.
(2) 1% of the total net patient revenue of all hospitals included in the assessment, as
reported in the Medicare cost report ending in federal FY 2013.
Further provides for the allocation of the assessment to each assessed hospital based on a pro
rata calculation. Authorizes the DHH to exclude certain hospitals from the assessment.
Provides for the assessment if the following occur:
(1) Implementation of the reimbursement enhancements from the payment for health
care services through the implementation of Medicaid expansion on or before April
1, 2016.
(2) The applicable federal financial participation for newly eligible Medicaid recipients
under Medicaid expansion is less than one hundred percent.
(3) Approval from the Joint Legislative Committee on the Budget of the proposed
assessment, including a list of each hospital that will be assessed.
Provides for reimbursement enhancements from the following:
(1)Payment for health care services through the implementation of Medicaid expansion.
(2)Payment of hospital inpatient and outpatient reimbursement rates which were in
effect on Dec. 31, 2010, or such rates that were in effect on June 30, 2013, whichever
is greater if there are adequate savings generated from the implementation of
Medicaid expansion and funds are appropriated in the budget.
Provides for a hospital base reimbursement level based on rates in effect on June 30, 2013.
Further provides for exceptions to the rates used to define and establish the base
reimbursement level.
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Appropriations to the
original bill:
1. Change the basis of reimbursement enhancements from rates that were in effect
on Dec. 31, 2010 to the greater of the rates that were in effect on Dec. 31, 2010,
or June 30, 2013.
The House Floor Amendments to the engrossed bill:
1. Provide for technical changes.
2. Add provision regarding the determination of the number of beds for hospitals
excluded from the assessment.
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