ENROLLED
2016 Regular Session
HOUSE CONCURRENT RESOL UTION NO. 51
BY REPRESENTATIVE BARRAS
1 A CONCURRENT RESOL UTION
2 To 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 provide for effectiveness; and to provide for related matters.
7 WHEREAS, in accordance with the Louisiana Constitution, the Legislature of
8 Louisiana hereby adopts the first subsequent hospital stabilization formula subsequent to the
9 formula in House Concurrent Resolution 75 of the 2015 Regular Session; and
10 WHEREAS, through the adoption of this Resolution, the Legislature of Louisiana
11 hereby seeks to:
12 (1)Preserve and enhance the availability of inpatient and outpatient hospital
13 services for the citizens of Louisiana.
14 (2)Preserve and protect rural hospitals as provided in the Rural Hospital
15 Preservation Act, pursuant to R.S. 40:1189.1 et seq.
16 (3)Enhance the stability of hospital funding by utilizing a fiscally-prudent
17 healthcare driven solution that does not rely on the use of state general fund
18 and provides a reliable and recurring source of funding for healthcare
19 services.
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1 (4)Minimize the effects of shifting the cost of caring for those Louisiana
2 citizens who are uninsured to those who are able to obtain health insurance.
3 (5)Create flexibility to design a plan to provide for more efficient and effective
4 ways to maximize the state's use of monies currently expended for the
5 provision of health care services to the state's low income and uninsured
6 residents.
7 THEREFORE, BE IT RESOLVED that the Legislature of Louisiana does hereby
8 enact the annual hospital stabilization formula pursuant to Article VII, Section 10.13 of the
9 Constitution of Louisiana:
10 I. Hospital Stabilization Assessment.
11 A. The Department of Health and Hospitals shall calculate, levy, and collect
12 an assessment for each assessed hospital in accordance with Subsection B of this
13 Section if all of the following occur:
14 (1) 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 (2) The Department of Health and Hospitals has submitted a Medicaid
17 assessment report to the Joint Legislative Committee on the Budget at least thirty
18 days prior to the department submitting any necessary documentation to the Centers
19 for Medicare and Medicaid Services for purposes of obtaining approval to implement
20 the assessment. The Medicaid assessment report shall include a description of the
21 proposed assessment, the basis for the calculation of the assessment, and a listing of
22 each hospital included in the proposed assessment.
23 (3) The Joint Legislative Committee on the Budget has not rejected the
24 Medicaid assessment report within thirty days after receiving the Medicaid
25 assessment report from the Department of Health and Hospitals.
26 B.(1) The total assessment for the state fiscal year shall be equal to, but shall
27 not exceed, the lesser of the following:
28 (a) The state portion of the cost, excluding any federal financial
29 participation, of the reimbursement enhancements provided for in Paragraph (1) of
30 Section II of this Resolution which are directly attributable to payments to hospitals.
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1 (b) One percent of the total inpatient and outpatient hospital net patient
2 revenue of all hospitals included in the assessment, as reported in the Medicare cost
3 report ending in state fiscal year 2015.
4 (2) The Department of Health and Hospitals shall allocate the assessment to
5 each assessed hospital on a pro rata basis by calculating the quotient of the total
6 assessment divided by the total inpatient and outpatient hospital net patient revenue
7 of all assessed hospitals as reported in the Medicare cost report ending in state fiscal
8 year 2015 and multiplying the quotient by each assessed hospital's total inpatient and
9 outpatient hospital net patient revenue. If a hospital was not required to file a
10 Medicare cost report or did not file a Medicare cost report ending in state fiscal year
11 2015, the hospital shall submit to the Department of Health and Hospitals its most
12 applicable calendar year total of inpatient and outpatient hospital net patient revenue
13 in a form prescribed by the department.
14 (3) The Department of Health and Hospitals shall levy and collect the
15 assessment provided for in this Section on a quarterly basis at the beginning of each
16 quarter that the assessment is due. Prior to levying or collecting the assessment for
17 the applicable quarterly period, the Department of Health and Hospitals shall publish
18 in the Louisiana Register the total amount of the quarterly assessment and the
19 corresponding applicable percentage of total inpatient and outpatient hospital net
20 patient revenue that will be applied to the assessed hospitals.
21 (4) The Department of Health and Hospitals shall publish on a quarterly
22 basis a report containing data directly related to the revenue enhancement provided
23 for in Paragraph (1) of Section II of this Resolution. The report shall include the
24 following:
25 (a) Total Medicaid enrollment on a monthly basis.
26 (b) The average monthly premium paid to managed care organizations
27 providing benefits and services to eligible Medicaid enrollees and the portion of
28 premium related to hospital payments.
29 (c) The aggregate Medicaid claims payment by provider type.
30 (d) The total amount of inpatient and outpatient Medicaid claims paid to
31 hospitals delineated by individual hospital.
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1 C.(1) The Department of Health and Hospitals shall exclude a hospital from
2 the assessment if the hospital meets the definition of a rural hospital as defined in
3 R.S. 40:1189.3.
4 (2) In the event the Centers for Medicare and Medicaid Services disapproves
5 any documentation submitted to the Centers for Medicare and Medicaid Services
6 that is necessary to obtain approval to implement the assessment, the Department of
7 Health and Hospitals may, notwithstanding the provisions of Paragraph (1) of this
8 Subsection, modify the submission to exclude the minimum number of hospitals
9 necessary to achieve approval of the assessment from the Centers for Medicare and
10 Medicaid Services. In addition, the Department of Health and Hospitals shall submit
11 a subsequent Medicaid assessment report to the Joint Legislative Committee on the
12 Budget in the same manner as required in Paragraphs (A)(2) and (3) of this Section.
13 II. Reimbursement Enhancements.
14 The Department of Health and Hospitals shall provide for reimbursement
15 enhancements as follows:
16 (1) Payment for health care services through the implementation of a health
17 coverage expansion of the Louisiana medical assistance program that meets all the
18 requirements necessary for the state to maximize federal matching funds as set forth
19 in 42 U.S.C. 1396d(y) of Title XIX of the Social Security Act.
20 (2) Effective January 1, 2017, provided that the Department of Health and
21 Hospitals implements a hospital stabilization assessment in accordance with the
22 provisions of this Resolution, for hospitals subject to any rate reduction after
23 December 31, 2010, payment of either the hospital inpatient and outpatient
24 reimbursement rates which were in effect on December 31, 2010, or such rates which
25 were in effect on June 30, 2013, whichever is greater, for hospital services provided
26 pursuant to the Louisiana medical assistance program.
27 III. Severability of Provisions
28 In accordance with R.S. 24:175, if any of the provisions of the Concurrent
29 Resolution which originated as House Concurrent Resolution No. 51 of the 2016
30 Regular Session of the Legislature or the application thereof is held invalid, such
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1 invalidity shall not affect other provisions or applications and to this end the
2 provisions of House Concurrent Resolution No. 51 are hereby declared severable.
3 IV. Effective Date
4 The hospital stabilization assessment and reimbursement enhancements
5 provided for in this Resolution shall be effective until July 1, 2019.
SPEAKER OF THE HOUSE OF REPRESENTATIVES
PRESIDENT OF THE SENATE
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED:
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