Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part V - Hospital Services
Subpart 5 - Outpatient Hospital Services
Chapter 51 - General Provisions
Section V-5109 - Children's Specialty Hospitals
Universal Citation: LA Admin Code V-5109
Current through Register Vol. 50, No. 3, March 20, 2024
A. In order to receive Medicaid reimbursement for outpatient services as a children's specialty hospital, the acute care hospital must meet the following criteria:
1.
be recognized by Medicare as a prospective payment system (PPS) exempt
children's specialty hospital;
2.
does not qualify for Medicare disproportionate share hospital payments;
and
3. has a Medicaid inpatient
days utilization rate greater than the mean plus two standard deviations of the
Medicaid utilization rates for all hospitals in the state receiving Medicaid
payments.
AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.
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