§ 46:2691 — Medicaid Trust Fund for the Elderly

§2691. Medicaid Trust Fund for the Elderly
A.(1) There is hereby established as a permanent trust fund in the state treasury
designated the "Medicaid Trust Fund for the Elderly", hereinafter referred to as the "fund".
After allocation of money to the Bond Security and Redemption Fund as provided in Article
VII, Section 9(B) of the Constitution of Louisiana, the treasurer shall deposit in and credit
to the fund the following sources:
(a) All money that is received from any source, including but not limited to an
intergovernmental transfer program provided for in this Chapter and all income on
investment of monies in the fund.
(b) Repealed by Acts 2019, No. 443, §4, eff. June 25, 2019.
(2) Monies in the fund shall be invested by the treasurer in the manner hereinafter
provided. All unencumbered and unexpended monies in the fund at the end of the fiscal year
shall remain in the fund.
(3) Monies in the fund may be used as the source of state matching funds for
Medicaid funds to make enhanced payments to local government-owned health care
facilities.
B.(1) After July 1, 2014, the principal in the fund from proceeds received by the state
associated with the Deepwater Horizon oil spill or any other source shall not be subject to
appropriation unless authorized by a joint resolution approved by two-thirds of the elected
members of each house of the legislature and except to provide for:
(a) The re-basing of nursing homes in accordance with the approved state Medicaid
plan.
(b) The development and funding of a case mix reimbursement system for the
Medicaid nursing home program.
(c) The payment of all costs of local governments for their participation in the
intergovernmental transfer program.
(d) The enhanced payment to any local government-owned health care facilities or
health care programs in amounts as required by written agreements between the secretary and
the local governments which are recommended by the Intergovernmental Transfer
Subcommittee created and established in R.S. 46:2692 and approved by the governor and the
Joint Legislative Committee on the Budget.
(e) The reimbursement of the Louisiana Department of Health for costs incurred in
preparing the application for and implementing the intergovernmental transfer program
established in this Chapter.
(f) The reimbursement of any monies deposited into the fund as a result of over
payments of federal funds.
(2) Upon completion of the initial intergovernmental transfer, nursing homes will
be re-based in accordance with the approved state Medicaid plan. In ensuing years, re-basing
in accordance with the approved state Medicaid plan may come from the principal in the
trust, but shall be limited to earnings on investment from the fund.
(3) Only earnings on investment from the fund may be appropriated each fiscal year
for services of the state Medicaid program in the following order of priority:
(a) For providing for a wage enhancement for direct care personnel working in
Medicaid certified nursing homes in accordance with a plan established by the Louisiana
Department of Health and representatives of the nursing facility industry. The plan shall
provide for a direct pass-through of the costs of such wage enhancement in a manner to
ensure that the nursing home rate is adjusted to reflect the full costs of such wage
enhancement.
(b) For appropriations solely and exclusively for services of the state Medicaid
program that are subject to federal financial participation in matching funds.
(4) Monies in the fund shall not be used to displace, replace, or supplant
appropriations from the state general fund for the Medicaid program below the amount of
state general fund appropriations for the Medicaid program for the 1999-2000 Fiscal Year
unless the official forecast of recurring monies available for appropriation which is utilized
by the legislature in its adoption of the state budget for the ensuring fiscal year as provided
in R.S. 39:26 indicates that revenues for such year will be insufficient to fund the state
budget at the same level as the previous year.
(5) The state treasurer shall report the status of the fund at least quarterly to the
secretary of the Louisiana Department of Health and the Intergovernmental Transfer
Subcommittee.
C.(1) The monies deposited in and credited to the fund pursuant to Subsection A of
this Section shall be invested by the state treasurer.
(2) The state treasurer is hereby authorized and directed to invest the monies
deposited in and credited to the fund that are available for investment in the investments
permitted for the Louisiana Education Quality Trust Fund, also known as the Kevin P. Reilly,
Sr. Louisiana Education Quality Trust Fund, as set forth in R.S. 17:3803(B), (D), and (E).
In establishing investment goals and policies for monies in the Medicaid Trust Fund for the
Elderly, the state treasurer shall consult no less frequently than semiannually with the
secretary of the Louisiana Department of Health as to the anticipated cash withdrawals from
the fund during the next twelve months.
(3) The earnings on investment from the fund shall be available to pay expenses
incurred for outside investment managers for the investment and management of the fund
and for other custody, investment, and disbursement costs directly attributable to the fund,
and as otherwise provided for in this Section.
(4) Expenses attributable to the state treasurer exercising responsibility for the
custody, investment, and disbursement of the monies in the fund are administrative costs
properly paid out of the earnings on investment from the fund and shall be paid by
appropriation from such earnings. Such costs include those costs attributable to fees charged
by any financial institution for providing custodial services, which shall not exceed two
percent of the amount managed, costs incurred for outside investment managers for the
investment and management of the fund, which shall not exceed two percent of the amount
managed and other direct costs incurred by the treasurer. Other costs related to the fund shall
be paid by appropriation from the state general fund. All appropriations made to, or upon
the request of, the state treasurer, related to the management of the fund shall be subject to
review of the Intergovernmental Transfer Subcommittee.
(5) The provisions of this Subsection shall be subject to review and approval of the
Centers for Medicare and Medicaid Services.
(6) On or before November first of each year, the state treasurer shall prepare and
submit to the secretary of the Louisiana Department of Health a report on the performance
of the fund during the prior fiscal year. The state treasurer shall also submit a copy of the
report to the Joint Legislative Committee on the Budget and to the House Committee on
Health and Welfare and the Senate Committee on Health and Welfare.

Legislative History

Acts 2000, 1st Ex. Sess., No. 143, §1, eff. April 19, 2000; Acts 2001, No. 700, §1; Acts 2005, No. 179, §11, eff. June 28, 2005; Acts 2013, No. 56, §3, eff. May 29, 2013; Acts 2013, No. 224, §1, eff. June 12, 2013; Acts 2014, No. 646, §12, eff. July 1, 2014; Acts 2019, No. 443, §4, eff. June 25, 2019.