This text of Louisiana § 40:1183.4 (Medical assistance programs; FQHC reimbursement) is published on Counsel Stack Legal Research, covering Louisiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
§1183.4. Medical assistance programs; FQHC reimbursement
A. The department shall adopt regulations that provide the following:
(1)A Medicaid cost-based reimbursement methodology that reimburses FQHCs for
all costs related to patients, utilizing the most recent cost report information available to the
department. The department shall seek to ensure that the reimbursement will be available
to FQHCs under the Medicaid program, either through payments received by FQHCs from
managed care organizations contracting with the department or its designee, or through
supplemental payments as necessary from the department based on availability of funds to
the extent permitted by federal law.
(2)With respect to disproportionate share payment methodologies, a reimbursement
methodology that reimburses f
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§1183.4. Medical assistance programs; FQHC reimbursement
A. The department shall adopt regulations that provide the following:
(1) A Medicaid cost-based reimbursement methodology that reimburses FQHCs for
all costs related to patients, utilizing the most recent cost report information available to the
department. The department shall seek to ensure that the reimbursement will be available
to FQHCs under the Medicaid program, either through payments received by FQHCs from
managed care organizations contracting with the department or its designee, or through
supplemental payments as necessary from the department based on availability of funds to
the extent permitted by federal law.
(2) With respect to disproportionate share payment methodologies, a reimbursement
methodology that reimburses for all net uncompensated costs for services delivered on an
outpatient basis through contracts with disproportionate share hospitals in an integrated
delivery system arrangement to the extent permitted by federal law and based on availability
of funds.
B. The regulations promulgated pursuant to Subsection A of this Section shall be
promulgated no later than one hundred twenty days after August 15, 1997. No later than one
hundred twenty days after August 15, 1997, the department shall also submit to the secretary
of the United States Department of Health and Human Services those amendments to the
state plan for medical assistance necessary to conform the state plan for medical assistance
with the provisions of Subsection A of this Section.
C. As of January 1, 2001, the department shall reimburse FQHCs for the delivery of
Medicaid services as provided in Sections 1902(a)(15) and 1902(aa) of the Social Security
Act, as added by Title VII Section 702 of the Medicare, Medicaid, and SCHIP Benefits
Improvement and Protection Act of 2000, hereinafter referred to as "BIPA" and included as
Appendix F of the Consolidated Appropriations Act of 2000, P.L. 106-554, and any pursuant
federal regulations.
D.(1) To the extent the department is unable to implement BIPA as of January 1,
2001, it shall reimburse FQHCs pursuant to BIPA requirements retroactive to January 1,
2001, but in no event shall such implementation begin any later than and in no event shall
such retroactive payment be made any later than July 1, 2002.
(2) In the event that the department chooses to apply an alternative payment
methodology to FQHCs as allowed under Section 1902(aa)(6), as amended by BIPA, such
methodology must be agreed to by the FQHC and cannot result in any less payment than the
FQHC would receive pursuant to the payment methodology set out in Section 1902(aa)(1)
through (5) of BIPA.