Louisiana 2021 2021 Regular Session

Louisiana House Bill HCR2 Introduced / Bill

                    HLS 21RS-531	ORIGINAL
2021 Regular Session
HOUSE CONCURRENT RESOL UTION NO. 2
BY REPRESENTATIVE SCHEXNAYDER
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; and to
6 provide for related matters.
7 WHEREAS, through the adoption of this Resolution, the Legislature of Louisiana
8hereby seeks to:
9 (1)Preserve and enhance the availability of inpatient and outpatient hospital
10	services for the citizens of Louisiana.
11 (2)Preserve and protect rural hospitals as provided in the Rural Hospital
12	Preservation Act, pursuant to R.S. 40:1189.1 et seq.
13 (3)Enhance the stability of hospital funding by utilizing a fiscally-prudent
14	healthcare driven solution that does not rely on the use of state general funds
15	and provides a reliable and recurring source of funding for healthcare
16	services.
17 (4)Minimize the effects of shifting the cost of caring for those Louisiana
18	residents who are uninsured to those who are able to obtain health insurance.
19 (5)Create flexibility to design a plan to provide for more efficient and effective
20	ways to maximize the state's use of monies currently expended for the
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1	provision of healthcare services to the state's low income and uninsured
2	residents.
3 THEREFORE, BE IT RESOLVED that the Legislature of Louisiana does hereby
4enact the annual hospital stabilization formula pursuant to Article VII, Section 10.13 of the
5Constitution of Louisiana:
6 I.  Hospital Stabilization Assessment.
7	A.(1)  The Louisiana Department of Health shall calculate, levy, and collect
8 an assessment for each assessed hospital in accordance with Subsection B of this
9 Section. 
10	(2)  Prior to the levy of any assessment pursuant to the provisions of this
11 Resolution, the Louisiana Department of Health shall submit a Medicaid assessment
12 report to the Joint Legislative Committee on the Budget.  The Medicaid assessment
13 report shall include a description of the proposed assessment, the basis for the
14 calculation of the assessment, and a listing of each hospital included in the proposed
15 assessment.
16	B.(1)  The total assessment for the state Fiscal Year 2021-2022 shall not
17 exceed the lesser of the following:
18	(a)  The state portion of the cost of the reimbursement enhancements
19 provided for in Subsection A of Section II of this Resolution which are directly
20 attributable to payments to hospitals, excluding any federal financial participation
21 and any costs associated with Full Medicaid Pricing, supplemental payments and
22 quality programs.  
23	(b)  One percent of the total inpatient and outpatient hospital net patient
24 revenue of all hospitals included in the assessment, as reported in the Medicare cost
25 report ending in state Fiscal Year 2015.  
26	(2)  The Louisiana Department of Health shall allocate, levy, and collect the
27 assessment in accordance with the provisions of the Louisiana Administrative Code
28 48:I.4001(F)(2) as published in Volume 42, Number 11, of the Louisiana Register
29 and with Subsection B of this Section.  Any hospital meeting the definition of a rural
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1 hospital as defined in R.S. 40:1189.3 or otherwise excluded by the Centers for
2 Medicare and Medicaid Services shall be excluded from the assessment.
3	(3)  The Louisiana Department of Health shall publish on a quarterly basis,
4 no later than thirty days after the end of each quarter, a report containing data
5 directly related to the revenue enhancement provided for in Subsection A of Section
6 II of this Resolution.  The report shall include the following:
7	(a)  Total Medicaid enrollment on a monthly basis. 
8	(b)  The average monthly premium paid to managed care organizations
9 providing benefits and services to eligible Medicaid enrollees and the portion of
10 premium related to hospital payments included in this assessment.
11	(c)  The aggregate Medicaid claims payment by provider type.
12	(d)  The total amount of inpatient and outpatient Medicaid claims paid to
13 hospitals delineated by each individual hospital Medicaid provider number.
14	II.  Reimbursement Enhancements.
15	The Louisiana Department of Health shall provide for reimbursement
16 enhancements as follows:
17	(A)  Payment for healthcare services through the implementation of a health
18 coverage expansion of the Louisiana medical assistance program that meets all the
19 requirements necessary for the state to maximize federal matching funds as set forth
20 in 42 U.S.C. 1396d(y) of Title XIX of the Social Security Act.
21	(B)  For any hospital subject to the assessment levied pursuant to this
22 Resolution, the payment of hospital reimbursement rates in an amount no less than
23 the reimbursement rates in effect for dates of service on or after January 1, 2021.
24	III.  Administration
25	The Louisiana Department of Health shall submit any necessary state plan
26 amendment that may be required in order to implement the provisions of this
27 Resolution to the Centers for Medicare and Medicaid Services no later than one
28 hundred and twenty days from the date this Resolution is adopted.
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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 2 Original 2021 Regular Session	Schexnayder
Provides for a hospital stabilization formula pursuant to Art. VII, ยง10.13 of the Constitution
of La., including assessments and reimbursement enhancements. 
Requires the La. Dept. of Health (LDH) to calculate, collect, and levy an assessment from
hospitals not to exceed the lesser of one of the following:
(1)The state portion of the cost of the reimbursement enhancements from the payment
for healthcare services through the implementation of Medicaid expansion which are
directly attributable to payments to hospitals, excluding any federal financial
participation and costs associated with Full Medicaid Pricing, supplemental
payments and quality programs. 
(2)1% of the total net patient revenue of all hospitals included in the assessment, as
reported in the Medicare cost report ending in state FY 2015.
Requires LDH to submit a Medicaid assessment report to the Joint Legislative Committee
on the Budget.
Provides for reimbursement enhancements as follows:
(1)Payment for healthcare services through the implementation of Medicaid expansion. 
(2)Payment of hospital reimbursement rates in an amount no less than the
reimbursement rates in effect for dates of service on or after Jan. 1, 2021, with the
exception of certain exclusions.
Requires LDH to quarterly publish a report that includes total Medicaid enrollment, average
monthly Medicaid managed care premium rates, aggregate claims by provider, and the total
amount of hospital claims by hospital.
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