HLS 25RS-787 ENGROSSED
2025 Regular Session
HOUSE BILL NO. 456
BY REPRESENTATIVE TURNER
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
MEDICAID: Provides relative to the Local Healthcare Provider Participation Program
1 AN ACT
2To amend and reenact R.S. 40:1248.3, 1248.5(D)(3), 1248.8(B) and (D), and 1248.9,
3 relative to the Local Healthcare Provider Participation Program; to provide for multi-
4 parish funding districts; to provide for power and duties of parishes; to provide for
5 local hospital assessment payments; to provide for applicability; to provide for an
6 effective date; and to provide for related matters.
7Be it enacted by the Legislature of Louisiana:
8 Section 1. R.S. 40:1248.3, 1248.5(D)(3), 1248.8(B) and (D), and 1248.9 are hereby
9amended and reenacted to read as follows:
10 §1248.3. Applicability; multi-parish funding district
11 A. The provisions of this Subpart shall apply to any parish in which at least
12 two institutional providers are located.
13 B.(1) If a parish has fewer than two hospitals, the parish may join with one
14 or more contiguous parishes with fewer than two hospitals and create a multi-parish
15 funding district, which shall be a new governmental entity. The boundary of a multi-
16 parish funding district shall be coextensive with the combined boundaries of the
17 parishes contained in the multi-parish funding district. A multi-parish funding
18 district shall be established by the governing body of each parish within the
19 boundaries of a proposed funding district passing and adopting a resolution or
20 ordinance establishing the multi-parish funding district and appointing one
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HB NO. 456
1 representative to serve on the multi-parish funding district's governing body. If any
2 other parish seeks to join after the creation of the district, the resolution or ordinance
3 shall be amended before the new parish may join the district.
4 (2) The governing body of a multi-parish funding district shall be comprised
5 solely of the individuals appointed by each parish within the boundaries of the
6 district. A parish may replace its appointment to the governing body by resolution
7 or ordinance.
8 (3) The governing body of a multi-parish funding district shall delegate the
9 operational and administrative burdens of the district to the parishes that comprise
10 the district. Within sixty days of the establishment of a multi-parish funding district,
11 the governing body shall designate at least one parish to serve as the operational and
12 administrative lead for the district. The governing body may change this designation
13 at any time.
14 (4) Solely for purposes of compliance with this Subpart, a multi-parish
15 funding district is considered to be a parish and the other provisions of this Subpart
16 shall be read to impose parish requirements on the governing body of the multi-
17 parish funding district.
18 * * *
19 §1248.5. Powers and duties of parishes; limitations; inspection of provider records
20 * * *
21 D.
22 * * *
23 (3) If a parish excludes providers pursuant to this Subsection or otherwise,
24 the definition of institutional provider as used in this Section and in R.S. 40:1248.8
25 shall be read to exclude such excluded providers, and, if necessary, the parish shall
26 be required to work with the department to obtain federal approvals to ensure
27 compliance with 42 U.S.C. 1396b(w).
28 * * *
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HB NO. 456
1 §1248.8. Local hospital assessment payments; basis; calculation
2 * * *
3 B. The assessment authorized by this Subpart shall be uniformly imposed on
4 each paying hospital in the parish in accordance with 42 U.S.C. 1396b(w) including
5 but not limited to 42 U.S.C. 1396(w)(3)(E). In accordance with 42 U.S.C. 1396b(w),
6 a local hospital assessment payment authorized by this Subpart shall not hold
7 harmless any institutional provider.
8 * * *
9 D. Subject to the maximum payment amount prescribed in Subsection C of
10 this Section, a parish that collects a local hospital assessment payment authorized by
11 this Subpart shall set local hospital assessment payments in amounts that, in the
12 aggregate, will generate sufficient revenue to cover the administrative expenses of
13 the parish for activities provided for in this Subpart and to fund the nonfederal share
14 of a Medicaid payment for the benefit of hospitals in the parish; except that the
15 amount of revenue from local hospital assessment payments used for administrative
16 expenses of the parish for activities provided for in this Subpart in a year, including
17 collection services as provided for in R.S. 40:1248.9, shall be one hundred fifty
18 thousand dollars may not exceed five percent of the total revenue generated from the
19 local hospital assessment payment or twenty thousand dollars, whichever is lower.
20 * * *
21 §1248.9. Local hospital assessment payments; collection
22 The sheriff of a Unless the parish engages an appropriate collection entity,
23 the parish shall collect the local hospital assessment payment authorized by this
24 Subpart. The sheriff shall charge and deduct from local hospital assessment
25 payments collected for the parish a fee for collecting those payments in an amount
26 determined by the parish. The fee shall not exceed the usual and customary charges
27 imposed by the sheriff.
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HB NO. 456
1 Section 2. This Act shall become effective upon signature by the governor or, if not
2signed by the governor, upon expiration of the time for bills to become law without signature
3by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If
4vetoed by the governor and subsequently approved by the legislature, this Act shall become
5effective on the day following such approval.
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 456 Engrossed 2025 Regular Session Turner
Abstract: Provides relative to the Local Healthcare Provider Participation Program.
Present law provides that the provisions of present law (R.S. 40:1248.1-1248.10) apply to
any parish where at least two institutional providers are located.
Proposed law revises present law to instead provide that present law applies to any parish.
Proposed law provides that if a parish has fewer than two hospitals, the parish may join with
one or more contiguous parishes with fewer than two hospitals and create a multi-parish
funding district, which shall be a new governmental entity. Proposed law further provides
that the boundary of a multi-parish funding district shall be coextensive with the combined
boundaries of the parishes contained in the multi-parish funding district.
Proposed law provides that a multi-parish funding district shall be established by the
governing body of each parish within the boundaries of a proposed funding district passing
and adopting a resolution or ordinance establishing the multi-parish funding district and
appointing one representative to serve on the multi-parish funding district's governing body.
Proposed law provides that the governing body of a multi-parish funding district shall be
comprised solely of the individuals appointed by each parish within the boundaries of the
district. Proposed law allows a parish to replace its appointment to the governing body by
resolution or ordinance.
Proposed law requires the governing body of a multi-parish funding district to delegate the
operational and administrative burdens of the district to the parishes that comprise the
district.
Proposed law requires, within 60 days of the establishment of a multi-parish funding district,
the governing body to designate at least one parish to serve as the operational and
administrative lead for the district. Proposed law allows the governing body to change this
designation at any time.
Present law provides that a rural hospital may be included in assessment payments imposed,
if the rural hospital and parish enter into a mutual agreement to include the rural hospital.
Proposed law retains present law.
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HB NO. 456
Present law provides that a governmental hospital may be included in assessment payments
imposed, if the governmental hospital and parish enter into a mutual agreement to include
the governmental hospital.
Proposed law retains present law.
Present law provides that if a parish excludes providers, the definition of institutional
provider as used in this present law (R.S. 40:1248.5 and 40:1248.8) shall be read to exclude
such excluded providers.
Proposed law adds that, if necessary, the parish shall be required to work with the
department to obtain federal approvals to ensure compliance with federal law. Proposed law
otherwise retains present law.
Present law provides that if a parish collects a local hospital assessment then the hospital
shall set local hospital assessment payments in amounts that, in the aggregate, will generate
sufficient revenue to cover the administrative expenses of the parish for activities as
specified in present law and to fund the nonfederal share of a Medicaid payment for the
benefit of hospitals in the parish.
Present law provides that the amount of revenue from local hospital assessment payments
used for the aforementioned reason may not exceed five percent of the total revenue
generated from the local hospital assessment payment or $20,000, whichever is lower.
Proposed law instead provides that the local assessment payments, including collection
services as provided in present law (R.S. 40:1248.9) as amended, shall be $150,000.
Proposed law otherwise retains present law.
Present law requires the sheriff of a parish to collect the local hospital assessment payment.
Present law allows the sheriff to charge and deduct from the assessment payment a fee for
collecting the payment. Present law further provides that the fee, which shall be in an
amount determined by the parish, shall not exceed the usual and customary charges imposed
by the sheriff.
Proposed law instead provides that the parish may only collect an assessment payment if the
parish uses an appropriate collection entity.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Amends R.S. 40:1248.3, 1248.5(D)(3), 1248.8(B) and (D), and 1248.9)
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Health and Welfare to
the original bill:
1. Clarify that a local hospital assessment payment will be imposed on each paying
hospital in the parish in accordance with federal law.
2. Make technical changes.
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