HLS 20RS-1301 REENGROSSED
2020 Regular Session
HOUSE BILL NO. 838
BY REPRESENTATIVE LYONS
MEDICAID MANAGED CARE: Provides relative to nonemergency, non-ambulance
medical transportation services delivered through the Medicaid managed care
program
1 AN ACT
2To enact Subpart F of Part XIII of Chapter 3 of Title 46 of the Louisiana Revised Statutes
3 of 1950, to be comprised of R.S. 46:460.101 through 460.103, relative to the state
4 medical assistance program known commonly as Medicaid; to provide relative to
5 nonemergency, non-ambulance medical transportation services; to provide for
6 administration of nonemergency, non-ambulance medical transportation services by
7 Medicaid managed care organizations; to provide requirements for contracts between
8 the Louisiana Department of Health and managed care organizations; to require
9 administrative rulemaking by the Louisiana Department of Health; and to provide
10 for related matters.
11Be it enacted by the Legislature of Louisiana:
12 Section 1. Subpart F of Part XIII of Chapter 3 of Title 46 of the Louisiana Revised
13Statutes of 1950, comprised of R.S. 46:460.101 through 460.103, is hereby enacted to read
14as follows:
15 SUBPART F. TRANSPORTATION PROGRAM
16 §460.101. Nonemergency, non-ambulance medical transportation; administration
17 by managed care organizations; contractual requirements
18 A. In any contract with a managed care organization with an effective date
19 of January 1, 2022, or after, the department shall require any managed care
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1 organization which utilizes a transportation broker to have a Louisiana-based call
2 center. Funding for the Louisiana-based call center provided through any such
3 contract shall not exceed the amount provided to the managed care organization for
4 call center services in the immediately preceding contract period.
5 B. In order to ensure fair competition among providers on a regional basis,
6 the department, through its contracts with managed care organizations, shall prohibit
7 an out-of-region nonemergency, non-ambulance medical transportation provider
8 from providing services to a Medicaid enrollee if there is a willing and available
9 nonemergency, non-ambulance medical transportation provider in the region where
10 the Medicaid enrollee is domiciled. The department shall provide in rule for the
11 boundaries of the regions which apply to this Subsection and for penalties for
12 providers which violate the out-of-region service prohibition established by this
13 Paragraph.
14 §460.102. Partnership for support of nonemergency, non-ambulance medical
15 transportation industry
16 The department may partner or otherwise enter into a formal relationship
17 with an association to accomplish the following:
18 (1) Promote uniformity in the nonemergency, non-ambulance medical
19 transportation industry.
20 (2) Set standards that elevate quality and promote trusted service.
21 (3) Provide opportunities for training and business counseling.
22 (4) Maintain a vetted, updated list of active nonemergency, non-ambulance
23 medical transportation providers.
24 (5) Develop a platform for all who work within the nonemergency, non-
25 ambulance medical transportation industry or utilize nonemergency medical
26 transportation services to receive the latest news and trends affecting the
27 nonemergency, non-ambulance medical transportation industry.
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HB NO. 838
1 §460.103. Administrative rulemaking
2 The department shall promulgate all rules and regulations in accordance with
3 the Administrative Procedure Act as may be necessary to implement the provisions
4 of this Subpart.
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)]
HB 838 Reengrossed 2020 Regular Session Lyons
Abstract: Provides for regulations and requirements concerning non-ambulance,
nonemergency medical transportation services delivered through the Medicaid
managed care program.
Proposed law applies to non-ambulance, nonemergency medical transportation (NEMT)
providers and services.
Proposed law provides that in any contract between the La. Department of Health (LDH) and
a Medicaid managed care organization (MCO) that has an effective date of Jan. 1, 2022, or
after, LDH shall require any MCO which utilizes a transportation broker to have a La.-based
call center. Stipulates that funding for the La.-based call center shall not exceed the amount
for call center services in the immediately preceding contract period.
Proposed law requires that, in order to ensure fair competition among NEMT providers on
a regional basis, LDH, through its contracts with MCOs, shall prohibit an out-of-region
NEMT provider from providing services to a Medicaid enrollee if there is a willing and
available NEMT provider in the region where the enrollee is domiciled. Requires LDH to
provide in rule for the boundaries of the regions which apply to proposed law and for
penalties for violation of the out-of-region service prohibition provided in proposed law.
Proposed law authorizes LDH to partner or otherwise enter into a formal relationship with
an association to accomplish the following:
(1)Promote uniformity in the non-ambulance NEMT industry.
(2)Set standards that elevate quality and promote trusted service.
(3)Provide opportunities for training and business counseling.
(4)Maintain a vetted, updated list of active non-ambulance NEMT providers.
(5)Develop a platform for all who work within the non-ambulance NEMT industry or
utilize NEMT services to receive the latest news and trends affecting the industry.
(Adds R.S. 46:460.101-460.103)
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HB NO. 838
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Health and Welfare to
the original bill:
1. Delete proposed law which would have required that the annual Medicaid
managed care transparency report issued by the La. Department of Health (LDH)
address payments to nonemergency medical transportation (NEMT) providers
and transportation brokers and third-party administrators in the Medicaid NEMT
program.
2. Specify that proposed law applies to non-ambulance NEMT providers.
3. Delete proposed law which would have mandated that LDH require by contract
that if a Medicaid managed care organization (MCO) hires or subcontracts with
any transportation broker or third-party administrator for the administration of
any aspect of its NEMT program, then that broker or administrator shall have its
call center located in La.
4. Delete proposed law which would have mandated that each MCO which hires or
subcontracts with any transportation broker or third-party administrator for the
administration of any aspect of its NEMT program shall require that the broker
or administrator have minority business partnerships with its call center.
5. Delete proposed law which would have mandated that LDH require by contract
that MCOs and their subcontractors report to the department the reimbursement
rates and total payments made to individual providers of NEMT services.
6. Stipulate that in any LDH contract with an MCO that has an effective date of Jan.
1, 2022, or after, the department shall require any MCO which utilizes a
transportation broker to have a La.-based call center.
7. Delete proposed law which would have required LDH to limit NEMT services
rendered by an individual provider to a specific region of the state and to provide
in MCO contracts for penalties for failure to enforce this limitation.
8. Require LDH, through its contracts with MCOs, to prohibit an out-of-region,
non-ambulance NEMT provider from providing services to a Medicaid enrollee
if there is a willing and available non-ambulance NEMT provider in the region
where the enrollee is domiciled; and to provide in rule for the boundaries of the
regions which apply to this provision and for penalties for violation of the
out-of-region service prohibition.
9. Authorize LDH to partner or otherwise enter into a formal relationship with an
association to accomplish the following:
(a)Promote uniformity to the non-ambulance NEMT industry.
(b)Set standards that elevate quality and trusted service.
(c)Provide opportunities for training and business counseling.
(d)Maintain a vetted, updated list of active non-ambulance NEMT
providers.
(e)Develop a platform for all that work within the non-ambulance NEMT
industry or utilize NEMT services to receive the latest news and trends
affecting the industry.
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10.Make technical changes.
The House Floor Amendments to the engrossed bill:
1. Stipulate that funding for the La.-based call center in the contract provided for
in proposed law shall not exceed the amount for call center services in the
immediately preceding contract period.
2. Make technical and corrective changes.
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