Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part V - Hospital Services
Subpart 5 - Outpatient Hospital Services
Chapter 51 - General Provisions
Section V-5111 - Hospital Provider-Based Outpatient Services

Universal Citation: LA Admin Code V-5111

Current through Register Vol. 50, No. 9, September 20, 2024

A. In order to receive Medicaid reimbursement as a hospital provider-based outpatient facility, an off-site campus of a hospital which provides outpatient services shall meet the provider-based requirements for Medicare as established in 42 CFR 413.65, except when the provisions in §5111. B are applicable.

B. Closure of a State-Owned and/or Operated Hospital. If a state-owned and/or operated hospital ceases to do business and surrenders its license, the off-site campus of that closed hospital may be deemed to be "provider-based" for purposes of Medicaid reimbursement only when all of the following criteria are met.

1. The off-site campus shall comply with the provider-based requirements in 42 CFR 413.65 except that:
a. the off-site campus shall be deemed in compliance with 42 CFR 413.65(d)(2)(vi) if the off-site campus refers patients requiring inpatient hospital services to either its main hospital provider campus or to the nearest available inpatient services; and

b. the off-site campus shall be deemed in compliance with 42 CFR 413.65(e)(3)(i) if they are licensed as an off-site campus of another state-owned and/or operated hospital that is within 100 miles of the off-site campus.

2. The off-site campus provides outpatient hospital services.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.