Current through Register Vol. 50, No. 3, March 20, 2024
A.
Payments to qualifying hospitals shall be made on a quarterly basis in
accordance with
42
CFR 447.321.
B. Effective for dates of service on or after
April 15, 2013, a major teaching hospital that enters into a cooperative
endeavor agreement with the Department of Health and Hospitals to provide acute
care hospital services to Medicaid and uninsured patients, and which assumes
providing services that were previously delivered and terminated or reduced by
a state owned and operated facility shall be reimbursed as follows.
1. Outpatient Surgery. The reimbursement
amount for outpatient hospital surgery services shall be an interim payment
equal to the Medicaid fee schedule amount on file for each service, and a final
reimbursement amount of 95 percent of allowable Medicaid cost.
2. Clinic Services. The reimbursement amount
for outpatient clinic services shall be an interim payment equal to the
Medicaid fee schedule amount on file for each service, and a final
reimbursement amount of 95 percent of allowable Medicaid cost.
3. Laboratory Services. The reimbursement
amount for outpatient clinical diagnostic laboratory services shall be the
Medicaid fee schedule amount on file for each service.
4. Rehabilitative Services. The reimbursement
amount for outpatient clinic services shall be an interim payment equal to the
Medicaid fee schedule amount on file for each service, and a final
reimbursement amount of 95 percent of allowable Medicaid cost.
5. Other Outpatient Hospital Services. The
reimbursement amount for outpatient hospital services other than clinical
diagnostic laboratory services, outpatient surgeries, rehabilitation services
and outpatient hospital facility fees shall be an interim payment equal to 95
percent of allowable Medicaid cost.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
36:254 and Title XIX of the Social Security
Act.
