The Louisiana Department of Health must define and calculate uncompensated care, set qualifying facilities and payment amounts, and require certain hospitals and facilities to report specified data to the department.
SUBPART A-1. UNCOMPENSATED CARE HOSPITAL PAYMENTS §1242. Uncompensated Care Hospital Payments A.(1) The Louisiana Department of Health shall specify in the Medicaid State Plan how uncompensated care is defined and calculated and shall determine what facilities qualify for uncompensated care payments and the amount of the payments. In determining payments as provided in this Subsection, the department shall prioritize local access to care and shall distribute uncompensated care payments in proportion to the amount and type of uncompensated care reported by all qualified facilities as required by rule and as allocated in appropriations to the medical vendor payments program. The secretary shall require, as a condition of payment of uncompensated care costs provided pursuant to this Subsection, that all state and nonstate hospitals, excluding rural hospitals included in the Rural Hospital Preservation Act and their provider-based rural health clinics, and other healthcare facilities report to the department patient-specific Louisiana Medicaid universal billing revenue code format data on the amount and type of uncompensated care provided and all requested data on the amount and type of other services and activities financed by uncompensated care payments. This data shall be reported electronically by each hospital or other facility on a quarterly schedule as required by the department. The secretary shall provide, after the close of each quarter, a detailed summary of reported information to the governor and the legislature. Hospitals defined in the Rural Hospital Preservation Act shall continue to report the data collected on the Louisiana Department of Health form "Schedule of Uncompensated Care Cost" in accordance with the state plan as approved by the Centers for Medicare and Medicaid Services. The secretary of the Louisiana Department of Health shall provide an annual report of the submitted information and related payments to the governor and the legislature and shall make such data available to the public on the department's website. In addition, if a hospital or other healthcare facility does not provide the required patient-specific data, the secretary of the department may withhold an amount equal to five percent of Medicaid payments due that provider. Such withholding shall increase by five percent for each successive month that the required data is not received, but the total amount withheld shall not exceed twenty-five percent of the total monthly amount due the facility. Upon receipt of the required data, the department shall pay the facility all amounts previously withheld as a result of the failure to submit the required data. A hospital or other healthcare facility subject to withholding pursuant to this Paragraph may request an administrative review as provided by R.S. 46:437.4. The format of the data submission shall be defined as the current mandated Louisiana Medicaid program format by the secretary of the department. (2) Nothing in this Subsection shall be construed to impede or preclude the Louisiana Department of Health from implementing the provisions of the Rural Hospital Preservation Act. B. The secretary of the Louisiana Department of Health shall, subject to approval from the Centers for Medicare and Medicaid Services, amend the state Medicaid plan to provide for Medicaid disproportionate share payments to hospitals operated by the LSU Health Sciences Center-New Orleans under the provision of federal law that permits the reimbursement of uncompensated cost up to one hundred seventy-five percent of allowable cost. Acts 2003, No. 906, §4, eff. July 1, 2003; Acts 2008, No. 540, §1; Acts 2022, No. 271, §§5, 9B; Redesignated from R.S. 46:2761. NOTE: Former R.S. 40:1242 redesignated as R.S. 40:1265.2 by HCR 84 of 2015 R.S.