Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part VII - Long Term Care
Subpart 3 - Intermediate Care Facilities for Persons with Intellectual Disabilities
Chapter 329 - Reimbursement Methodology
Subchapter A - Non-State Facilities
Section VII-32917 - Dedicated Program Funding Pool Payments
Universal Citation: LA Admin Code VII-32917
Current through Register Vol. 50, No. 9, September 20, 2024
A. Effective for providers active and Medicaid certified as of September 1, 2019; a one-time lump sum payment will be made to intermediate care facilities for individuals with intellectual disabilities (ICFs/IID).
B. Methodology
1. Payment will be based on each
providers specific pro-rated share of an additional dedicated program funding
pool totaling $4,665,635.
2. The
pro-rated share for each provider will be determined utilizing the providers
percentage of total annualized program Medicaid days. Annualized program
Medicaid days will be calculated utilizing the most recently desk reviewed or
audited cost reports as of July 1, 2019.
3. The additional dedicated program funding
pool lump sum payments shall not exceed the Medicare upper payment limit in the
aggregate for the provider class.
4. The one-time payment will be made on or
before June 30, 2020.
5. Payment of
the one-time lump sum payment is subject to approval by the U.S. Department of
Health and Human Services, Centers for Medicaid and Medicare Services
(CMS).
C. Effective for providers
active and Medicaid certified as of July 1, 2022, a one-time, lump sum payment
will be made to non-state, non-public intermediate care facilities for
individuals with intellectual disabilities (ICFs/IID).
1. Methodology
a. Payment will be based on each provider's
specific pro-rated share of an additional dedicated program funding pool
totaling $27,974,178.
b. The
pro-rated share for each provider will be determined utilizing the provider's
percentage of program Medicaid days for dates of service in a three consecutive
month period selected by the department occurring between January 1, 2022 and
December 31, 2022.
c. If the
additional dedicated program funding pool lump sum payments exceed the Medicare
upper payment limit in the aggregate for the provider class, the department
shall recoup the overage using the same means of distribution in
§
32917.C.1.b
above.
d. The one-time payment will
be made on or before June 30, 2023.
e. All facilities receiving payment shall be
open and operating as an ICF/IID at the time the payment is made.
f. Payment of the one-time, lump sum payment
is subject to approval by the U.S. Department of Health and Human Services,
Centers for Medicare and Medicaid Services (CMS).
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.
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