This text of Louisiana § 40:2006.1 (Fees for Medicare surveys) 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.
§2006.1. Fees for Medicare surveys
A. As used in this Section, the terms below shall mean the following:
(1)"CMS" means the Centers for Medicare and Medicaid Services or any successor
agency within the United States Department of Health and Human Services charged with
administering the Medicare program.
(2)"Initial Medicare survey" means the site visit conducted by the state survey
department for the purpose of gathering information on a health care provider's level of
compliance with Medicare participation and other federal regulatory requirements. A survey
is considered an initial Medicare survey if the survey is required in order for a health care
provider to receive Medicare program payment for the first time as a type or class of health
care provider or in order to receive Medicare
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§2006.1. Fees for Medicare surveys
A. As used in this Section, the terms below shall mean the following:
(1) "CMS" means the Centers for Medicare and Medicaid Services or any successor
agency within the United States Department of Health and Human Services charged with
administering the Medicare program.
(2) "Initial Medicare survey" means the site visit conducted by the state survey
department for the purpose of gathering information on a health care provider's level of
compliance with Medicare participation and other federal regulatory requirements. A survey
is considered an initial Medicare survey if the survey is required in order for a health care
provider to receive Medicare program payment for the first time as a type or class of health
care provider or in order to receive Medicare reimbursement under a special Medicare
payment methodology. The fact that a health care provider may avoid a survey by obtaining
accreditation from a national accrediting body shall not affect a survey's status as an initial
Medicare survey.
(3) "State survey budget" means the dollar amount that CMS will pay the state
survey department in order to perform its functions as the state survey department during a
federal fiscal year.
(4) "State survey department" means the Louisiana Department of Health or its
successor.
B. If the state survey department determines that the state survey budget is
insufficient to perform all of the initial Medicare surveys it has been requested to perform
for the federal fiscal year, or the state survey department has not received final budget
appropriation for the state survey budget, the state survey department shall, upon the consent
of the party requesting an initial Medicare survey, assess a fee for the initial Medicare survey.
The fee shall be commensurate with the cost of performing the initial Medicare survey and
shall range from five hundred fifty dollars to two thousand three hundred dollars based upon
the provider type for which the initial Medicare survey is requested. Upon approval by the
Centers for Medicare and Medicaid Services, and upon execution of a written agreement to
pay the fee by the party requesting the initial Medicare survey and the state survey
department, the state survey department shall schedule and conduct the initial Medicare
survey. Upon determination that the final state survey budget appropriation is insufficient
to conduct the requested initial Medicare survey, the state survey department shall transmit
an invoice to the party that requested the initial Medicare survey. The invoiced amount shall
be the fee agreed upon by the state survey department and the party that requested the initial
Medicare survey. The party that requested the initial survey shall pay the invoice no later
than June thirtieth of the state fiscal year in which the initial Medicare survey was performed.
C. If the state survey department determines that the state survey budget is
insufficient to perform all of the initial Medicare surveys it has been requested to perform
during the federal fiscal year or the state survey department has not received final budget
appropriation for the state survey budget, the state survey department shall give priority to
all initial Medicare surveys requested by a rural hospital as defined in the Rural Hospital
Preservation Act. The order of initial Medicare surveys shall be determined on the basis of
the order in which parties requesting initial Medicare surveys complete the application
process.
D. Upon receipt of an application for a license from any person, partnership,
corporation, unincorporated association, or any other legal entity that has made a request for
an initial Medicare survey, under the circumstances in Subsection B of this Section, the state
survey department shall make a determination of whether it has sufficient state funds to
conduct an initial state licensure survey. In the event that the state survey department
determines that it lacks sufficient state funds, upon the consent of the party requesting the
initial state licensure survey, the state survey department shall assess a fee to defray the costs
associated with such initial state licensure survey. The fee shall be commensurate with the
cost of performing the initial state licensure survey and shall range from six hundred dollars
to two thousand six hundred fifty dollars based upon the provider type for which the initial
state licensure survey is requested. Upon payment of the fee by the party requesting the
initial state licensure survey, the state survey department shall schedule and conduct the
initial state licensure survey.