ENROLLED
ACT No. 432
2024 Regular Session
HOUSE BILL NO. 558
BY REPRESENTATIVES TURNER AND THOMPSON
1 AN ACT
2 To amend and reenact R.S. 40:1248.1(3) and (6), 1248.3, 1248.7(A) and (C)(1) and (2), and
3 1248.8(A) through (D), to enact R.S. 40:1248.1(7) and 1248.5(D), and to repeal R.S.
4 40:1248.11 and 1248.12, relative to the Local Healthcare Provider Participation
5 Program; to provide for definitions; to provide for parish applicability; to identify
6 providers subject to the local hospital assessment payments; to provide a basis by
7 which hospital payments shall be assessed; to provide for an effective date; to repeal
8 provisions relative to enhanced reimbursement for rural and governmental
9 institutional providers; and to provide for related matters.
10 Be it enacted by the Legislature of Louisiana:
11 Section 1. R.S. 40:1248.1(3) and (6), 1248.3, 1248.7(A) and (C)(1) and (2), and
12 1248.8(A) through (D) are hereby amended and reenacted and R.S. 40:1248.1(7) and
13 1248.5(D) are hereby enacted to read as follows:
14 §1248.1. Definitions
15 As used in this Subpart, the following terms have the meaning ascribed to
16 them in this Section:
17 * * *
18 (3) "Institutional provider" means a nongovernmental hospital licensed in
19 accordance with the Hospital Licensing Law, R.S. 40:2100 et seq. a governmental
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1 institutional provider, nongovernmental institutional provider, or rural hospital, as
2 applicable, located in participating parishes.
3 * * *
4 (6) "Rural institutional provider Rural hospital" means a rural hospital, other
5 than one as defined in R.S. 40:1189.3, that is licensed by the department, has no
6 more than sixty hospital beds on November 1, 2020, and meets any of the following
7 criteria:.
8 (a) Is located in a municipality with a population of not less than seven
9 thousand persons and not more than seven thousand five hundred persons according
10 to the most recent federal decennial census and in a parish with a population of not
11 less than thirty thousand persons and not more than thirty-five thousand persons
12 according to the most recent federal decennial census.
13 (b) Is located in a municipality with a population of not less than ten
14 thousand persons and not more than ten thousand five hundred persons according to
15 the most recent federal decennial census and in a parish with a population of not less
16 than eighty thousand persons and not more than ninety thousand persons according
17 to the most recent federal decennial census.
18 (c) Is located in a municipality with a population of not less than three
19 thousand persons and not more than three thousand five hundred persons according
20 to the most recent federal decennial census and in a parish with a population of not
21 less than thirty thousand persons and not more than thirty-five thousand persons
22 according to the most recent federal decennial census.
23 (7) "Nongovernmental institutional provider" means a hospital licensed in
24 accordance with the Hospital Licensing Law, R.S. 40:2100 et seq., that is not a
25 governmental institutional provider or rural hospital.
26 * * *
27 §1248.3. Applicability
28 The provisions of this Subpart shall apply exclusively to the following
29 parishes: any parish in which at least two institutional providers are located.
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1 (1) Any parish with a population of not less than forty thousand persons and
2 not more than forty-two thousand persons according to the most recent federal
3 decennial census.
4 (2) Any parish with a population of not less than forty-six thousand persons
5 and not more than forty-seven thousand persons according to the most recent federal
6 decennial census.
7 (3) Any parish in which a rural institutional provider is located.
8 * * *
9 §1248.5. Powers and duties of parishes; limitations; inspection of provider records
10 * * *
11 D.(1) A rural hospital may be included in assessment payments imposed
12 pursuant to this Subpart if the rural hospital and parish enter into a mutual agreement
13 to include the rural hospital.
14 (2) A governmental hospital may be included in assessment payments
15 imposed in accordance with this Subpart if the governmental hospital and parish
16 enter into a mutual agreement to include the governmental hospital.
17 (3) If a parish excludes providers, the definition of institutional provider as
18 used in this Section and in R.S. 40:1248.8 shall be read to exclude such excluded
19 providers.
20 * * *
21 §1248.7. Local provider participation fund; authorized uses
22 A. Each parish that collects a local hospital assessment payment authorized
23 by this Subpart or in which a rural institutional provider is located shall create a local
24 provider participation fund. All income received by a parish pursuant to the
25 provisions of this Subpart, including the revenue from local hospital assessment
26 payments remaining after discounts and fees for assessing and collecting the
27 payments are deducted, shall be deposited in the local provider participation fund of
28 the parish. Monies in the fund may be withdrawn only in accordance with and for
29 purposes specified in the provisions of this Section.
30 * * *
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1 C. Monies in the local provider participation fund may be used only for one
2 or more of the following purposes:
3 (1) To fund intergovernmental transfers from a parish to the state to provide
4 the nonfederal share of a program of Medicaid payments for the benefit of rural
5 institutional providers or other hospitals in the parish authorized under the Medicaid.
6 state plan.
7 (2) To pay the administrative expenses of a parish associated exclusively
8 with activities authorized by this Subpart in an amount not to exceed the amount
9 specified in R.S. 40:1248.8 five percent of the local hospital assessment payment.
10 * * *
11 §1248.8. Local hospital assessment payments; basis; calculation
12 A. Except as provided in Subsection E of this Section, a parish that collects
13 a local hospital assessment payment authorized by this Subpart may require an
14 annual local hospital assessment payment to be assessed quarterly using any basis
15 permitted by 42 U.S.C. 1396b(w)(3) on the net patient revenue of each institutional
16 provider located in the parish. In the first year in which the local hospital assessment
17 payment is required, the local hospital assessment payment shall be assessed on the
18 net patient revenue of an institutional provider as determined by the most recently
19 filed Medicaid cost report. The parish shall update the amount of the local hospital
20 assessment payment on an annual basis.
21 B. The amount of a local hospital assessment payment authorized by this
22 Subpart shall be uniformly imposed on proportionate with the amount of net patient
23 revenue generated by each paying hospital in the parish. In accordance with 42
24 U.S.C. 1396b(w), a local hospital assessment payment authorized by this Subpart
25 shall not hold harmless any institutional provider.
26 C. A parish that collects a local hospital assessment payment authorized by
27 this Subpart shall set the amount of the local hospital assessment payment. The
28 amount of the local hospital assessment payment required of paying hospitals may
29 not exceed an amount that, when added to the amounts amount of the local hospital
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1 assessment payment required of each paying hospital may not exceed an amount
2 that, when added to the amount of the local hospital assessment payments required
3 from all other paying hospitals in the parish, and the amount of any other assessment,
4 local hospital assessment payment, or tax imposed by the state with a similar
5 purpose, equals an amount of revenue that exceeds six percent of the aggregate net
6 patient revenue of all paying hospitals in the parish state. The local hospital
7 assessment shall also meet all other relevant Centers for Medicare and Medicaid
8 Services tests. No later than the twentieth day before a hearing to set a rate pursuant
9 to R.S. 40:1248.6, a parish shall inform the department of the amount of revenue to
10 be collected under the proposed assessment. If the department determines that the
11 proposed assessment will trigger federal compliance issues, including issues with
12 respect to the six percent limit, the department shall inform the parish, prior to the
13 hearing, of any necessary reductions in the amount to be collected or changes
14 necessary to comply with federal requirements. If the parish does not follow
15 recommendations or requests from the department, the department may terminate,
16 or refuse to enter into, any intergovernmental transfer agreements with the parish.
17 D. Subject to the maximum payment amount prescribed in Subsection C of
18 this Section, a parish that collects a local hospital assessment payment authorized by
19 this Subpart shall set local hospital assessment payments in amounts that in the
20 aggregate will generate sufficient revenue to cover the administrative expenses of the
21 parish for activities provided for in this Subpart and to fund the nonfederal share of
22 a Medicaid base rate payment payment for the benefit of hospitals in the parish;
23 except that the amount of revenue from local hospital assessment payments used for
24 administrative expenses of the parish for activities provided for in this Subpart in a
25 year may not exceed five percent of the total revenue generated from the local
26 hospital assessment payment or twenty thousand dollars, whichever is lower greater.
27 * * *
28 Section 2. R.S. 40:1248.11 and 1248.12 are repealed in their entirety.
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1 Section 3. This Act shall become effective upon signature by the governor or, if not
2 signed by the governor, upon expiration of the time for bills to become law without signature
3 by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If
4 vetoed by the governor and subsequently approved by the legislature, this Act shall become
5 effective on the day following such approval.
SPEAKER OF THE HOUSE OF REPRESENTATIVES
PRESIDENT OF THE SENATE
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED:
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