§ 40:1242 — 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.
NOTE: Former R.S. 40:1242 redesignated as R.S. 40:1265.2 by HCR 84 of 2015
R.S.

Legislative History

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.