ENROLLED
2020 First Extraordinary Session
HOUSE CONCURRENT RESOL UTION NO. 2
BY REPRESENTATIVES SCHEXNAYDER AND THOMPSON
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; and 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. 40:1189.1 et seq.
(3)Enhance the stability of hospital funding by utilizing a fiscally-prudent
healthcare driven solution that does not rely on the use of state general funds
and provides a reliable and recurring source of funding for healthcare
services.
(4)Minimize the effects of shifting the cost of caring for those Louisiana
residents 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 healthcare services to the state's low income and uninsured
residents.
THEREFORE, BE IT RESOLVED that the Legislature of Louisiana does hereby
enact the annual hospital stabilization formula pursuant to Article VII, Section 10.13 of the
Constitution of Louisiana:
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I. Hospital Stabilization Assessment.
A. The Louisiana Department of Health 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) 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.
(2) The Louisiana Department of Health has submitted a Medicaid assessment report
to the Joint Legislative Committee on the Budget. The Medicaid assessment report shall
include a description of the proposed assessment, the basis for the calculation of the
assessment, and a listing of each hospital included in the proposed assessment.
B.(1) The total assessment for the State Fiscal Year 2020-2021 shall not exceed the
lesser of the following:
(a) The state portion of the cost of the reimbursement enhancements provided for
in Subsection A of Section II of this Resolution which are directly attributable to payments
to hospitals, excluding any federal financial participation and any costs associated with Full
Medicaid Pricing, supplemental payments and quality programs.
(b) One percent of the total inpatient and outpatient hospital net patient revenue of
all hospitals included in the assessment, as reported in the Medicare cost report ending in
State Fiscal Year 2015.
(2) The Louisiana Department of Health shall allocate, levy, and collect the
assessment in accordance with the provisions of the Louisiana Administrative Code
48:I.4001(F)(2) as published in Volume 42, Number 11, of the Louisiana Register and with
Subsection B of this Section. Any hospital meeting the definition of a rural hospital as
defined in R.S. 40:1189.3 shall be excluded from the assessment. Subject to the approval
of the Centers for Medicare and Medicaid Services, any hospital under fifty beds shall be
exempt from the hospital assessment from January 1, 2020 through July 31, 2020.
(3) The Louisiana Department of Health shall publish on a quarterly basis, no later
than thirty days after the end of each quarter, a report containing data directly related to the
revenue enhancement provided for in Subsection A of Section II of this Resolution. The
report shall include the following:
(a) Total Medicaid enrollment on a monthly basis.
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(b) The average monthly premium paid to managed care organizations providing
benefits and services to eligible Medicaid enrollees and the portion of premium related to
hospital payments included in this assessment.
(c) The aggregate Medicaid claims payment by provider type.
(d) The total amount of inpatient and outpatient Medicaid claims paid to hospitals
delineated by each individual hospital Medicaid provider number.
II. Reimbursement Enhancements.
The Louisiana Department of Health shall provide for reimbursement enhancements
as follows:
A. Payment for healthcare 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.
B. Payment of hospital reimbursement rates in an amount no less than the
reimbursement rates in effect for dates of service on or after January 1, 2020.
C. For dates of service on or after January 1, 2021, reimbursement rates for inpatient
hospital services and outpatient hospital surgery services shall be increased by an amount
equal to the value of the "Four-quarter Moving Average Percent Change" of the CMS
Market Basket Index for Inpatient Hospital for the second quarter of the Federal Fiscal Year
2020-2021 as published by CMS on December 9, 2019.
III. Administration
The Louisiana Department of Health shall submit any necessary state plan
amendment that may be required in order to implement the provisions of this Resolution to
the Centers for Medicare and Medicaid Services no later than one hundred and twenty days
from the date this Resolution is adopted.
SPEAKER OF THE HOUSE OF REPRESENTATIVES
PRESIDENT OF THE SENATE
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