Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part XXXIII - Behavioral Health Services
Subpart 13 - Therapeutic Group Homes
Chapter 127 - Reimbursement
Section XXXIII-12701 - General Provisions
Current through Register Vol. 50, No. 9, September 20, 2024
A. The department or its fiscal intermediary shall make monthly capitation payments to the MCOs. The capitation rates paid to the MCOs shall be actuarially sound rates and the MCOs will determine the rates paid to its contracted providers. No payment shall be less than the minimum Medicaid rate.
B. All in-state Medicaid participating TGH providers are required to file an annual Medicaid cost report according to the departments specifications and departmental guides and manuals.
C. Costs reports must be submitted annually. The due date for filing annual cost reports is the last day of the fifth month following the facility's fiscal year end. Separate cost reports must be filed for the facilities central/home office when costs of that entity are reported on the facilities cost report. If the facility experiences unavoidable difficulties in preparing the cost report by the prescribed due date, a filing extension may be requested. A filing extension must be submitted to Medicaid prior to the cost report due date.
D. Services provided by psychologists and licensed mental health practitioners shall be billed to the MCO or CSoC contractor separately.
AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.