ENROLLED
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
A CONCURRENT RESOL UTION
To provide for a hospital stabilization formula pursuant to Article VII, Section 10.13 of the
Constitution of Louisiana; to establish the level and basis of hospital assessments;
to establish certain reimbursement enhancements for inpatient and outpatient hospital
services; to establish certain criteria for the implementation of the formula; to
establish the base reimbursement level paid to hospitals; to provide for related
matters.
WHEREAS, through the adoption of this Resolution, the Legislature of Louisiana
hereby seeks to:
(1)Preserve and enhance the availability of inpatient and outpatient hospital
services for the citizens of Louisiana.
(2)Preserve and protect rural hospitals as provided in the Rural Hospital
Preservation Act, pursuant to R.S. 40:1300.141 et seq.
(3)Enhance the stability of hospital funding by utilizing a healthcare driven
solution which provides a reliable and recurring source of funding for
healthcare services.
(4)Minimize the effects of shifting the cost of caring for those Louisiana
citizens who are uninsured to those who are able to obtain health insurance.
(5)Create flexibility to design a plan to provide for more efficient and effective
ways to maximize the state's use of monies currently expended for the
provision of health care services to the state's low income and uninsured
residents.
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THEREFORE, BE IT RESOLVED that the Legislature of Louisiana does hereby
enact the following hospital stabilization formula pursuant to Article VII, Section 10.13 of
the Constitution of Louisiana:
I. Hospital Stabilization Assessment.
A. The Department of Health and Hospitals shall calculate, levy, and collect
an assessment for each assessed hospital in accordance with Subsection B of this
Section if all of the following occur:
(1) Implementation of the reimbursement enhancements as provided for in
Paragraph (1) of Section II of this Resolution on or before April 1, 2016.
(2) The applicable federal financial participation, as set forth in 42 U.S.C.
1396d(y) of Title XIX of the Social Security Act, 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.
B.(1) The total assessment for the state fiscal year shall be equal to, but shall
not exceed, the lesser of the following:
(a) The state portion of the cost, excluding any federal financial
participation, of the reimbursement enhancements provided for in Paragraph (1) of
Section II of this Resolution which are directly attributable to payments to hospitals.
(b) One percent of the total net patient revenue of all hospitals included in
the assessment, as reported in the Medicare cost report ending in federal fiscal year
2013.
(2) The Department of Health and Hospitals shall allocate the assessment to
each assessed hospital on a pro rata basis by calculating the quotient of the total
assessment divided by the total net patient revenue of all assessed hospitals as
reported in the Medicare cost report ending in federal fiscal year 2013 and
multiplying the quotient by each assessed hospital's total net patient revenue. If a
hospital was not required to file a Medicare cost report or did not file a Medicare
cost report ending in federal fiscal year 2013, the hospital shall submit to the
Department of Health and Hospitals its most applicable fiscal year total of net patient
revenue in a form prescribed by the department.
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(3) The Department of Health and Hospitals shall levy and collect the
assessment provided for in this Section on a quarterly basis. Prior to levying or
collecting the assessment for the applicable quarterly period, the Department of
Health and Hospitals shall publish in the Louisiana Register the total amount of the
quarterly assessment and the corresponding applicable percentage of total net patient
revenue that will be applied to the assessed hospitals.
C.(1) The Department of Health and Hospitals shall exclude a hospital from
the assessment if any of the following are applicable:
(a) The hospital is certified by Medicare as a separately licensed long-term
acute care, rehabilitation, or psychiatric hospital.
(b) The hospital has sixty or less beds, either as reported in the Medicare cost
report ending in federal fiscal year 2013 or as licensed by the Department of Health
and Hospitals on December 31, 2013.
(c) The hospital meets the definition of a rural hospital as defined in R.S.
40:1300.143.
(2) The Department of Health and Hospitals may also exclude a hospital or
class of hospitals which is necessary to achieve approval of the assessment from the
Centers for Medicare and Medicaid Services.
II. Reimbursement Enhancements.
The Department of Health and Hospitals shall provide for reimbursement
enhancements as follows:
(1) Payment for health care services through the implementation of a health
coverage expansion of the Louisiana medical assistance program that meets all the
requirements necessary for the state to maximize federal matching funds as set forth
in 42 U.S.C. 1396d(y) of Title XIX of the Social Security Act.
(2) Payment of either the hospital inpatient and outpatient reimbursement
rates which were in effect on December 31, 2010, or such rates which were in effect
on June 30, 2013, whichever is greater, for hospital services provided pursuant to the
Louisiana medical assistance program provided that there are adequate savings
generated from the implementation of a health coverage expansion as provided for
in this Section and funds are appropriated in the budget.
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III. Hospital Base Reimbursement Level.
The hospital base reimbursement level is hereby defined and established as
all inpatient and outpatient hospital reimbursement rates and methodologies under
the state plan for the Louisiana medical assistance program, including, but not
limited to inpatient peer group per diem rates, outpatient fee schedules, outpatient
cost reimbursed services and cost report settlements, supplemental, outlier, and other
special payments, including Medicaid Disproportionate Share Hospital payments,
and all other polices and methodologies related to claims administration,
reimbursement, and adjudications adopted by the Department of Health and
Hospitals in effect on June 30, 2013, except for the following amendments to the
state plan for the Louisiana medical assistance program:
(1) Any amendment approved by the Centers for Medicare and Medicaid
Services after June 30, 2013, regardless of the effective date of the amendment.
(2) Amendments identified by the following transmittal numbers:
(a) TN 09-55.
(b) TN 09-56.
(c) TN 10-26.
SPEAKER OF THE HOUSE OF REPRESENTATIVES
PRESIDENT OF THE SENATE
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