reglab/statecodes huggingface dataset:
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1231.9. Reporting of claims

RS 40:1231.9 - Reporting of claims
A. For the purpose of providing the various licensing boards of Louisiana health care providers, as defined by R.S. 40:1231.1(A), with information on malpractice claims paid by insurers or self insurers on behalf of health care providers in this state, each insurer of such health care provider, and each health care provider in Louisiana who is self insured shall, within thirty days of the date of payment, provide a written report to the licensing board of this state having licensing authority over the health care provider on whose behalf payment was made, and each such report shall contain:
(1) The name and address of the health care provider.
(2) A brief description of the acts of omission or commission which gave rise or allegedly gave rise to the claim, and the date thereof.
(3) The name of the patient and the injury which resulted or allegedly resulted therefrom.
(4) The amount paid in settlement or discharge of the claim, whether paid by compromise, by payment of judgment, by payment of arbitration award, or otherwise; and
(5) Where any judicial opinion has been rendered with regard to a claim, a copy of all such opinions shall be attached to the report.
Provided, however, no report shall be required for compromise settlements of claims where the amount paid is one thousand dollars or less, except where such payments were made in satisfaction or compromise of judgment of court or of award of arbitrators.
B. The provisions of this Section shall apply to all health care providers in Louisiana, whether or not such health care provider has qualified under the provisions of this Part.
C. There shall be no liability on the part of any insurer or person acting for said insurer, for any statements made in good faith in the reports required by this Section.
D.(1) The executive director of the Patient's Compensation Fund shall submit a report on an annual basis to the Senate and House committees on health and welfare no later than January thirty-first. The report shall contain every claim against an individual practitioner who has had five or more paid claims for the previous year paid by the Patient's Compensation Fund and shall contain the following information:
(a) All paid claims for the previous year and the year immediately preceding that year, as well as the total number of pending claims filed against that individual practitioner.
(b) The name and address of the individual practitioner and a brief description of the acts of omission or commission which gave rise to the paid claims.
(2) For the purposes of this Subsection, "individual practitioner" means any individual person licensed or certified by this state to provide health care or professional services who is listed in R.S. 40:1231.1(A)(10).
Added by Acts 1976, No. 114, §1; Redesignated from R.S. 40:1299.48 by HCR 84 of 2015 R.S.; Acts 2015, No. 454, §1, eff. July 1, 2015.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1231.10. Medical review panel; one panel for state and private claims

RS 40:1231.10 - Medical review panel; one panel for state and private claims
The following provisions shall apply when, for the same injury to or death of a patient, a malpractice claim alleges liability of both a state health care provider under the provisions of this Part and a health care provider under the provisions of Part IV of this Subchapter:
(1) Unless all parties have agreed otherwise, only one medical review panel shall be convened in such instance to review the claims under this Part and Part IV of this Subchapter.
(2) The panel shall consist of a single attorney chairperson and three health care providers who hold unlimited licenses to practice their profession in Louisiana.
(3) The panel shall be considered a joint medical review panel, and its actions shall be deemed to have the same force and effect as if a separate medical review panel had been convened under each of the respective Parts.
(4) The panel shall be governed by the law applicable under both Parts. In the event of a procedural conflict between the provisions of the Parts, the provisions of R.S. 40:1231.8 shall govern.
Acts 2004, No. 183, §1, eff. June 10, 2004; Redesignated from R.S. 40:1299.49 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1232. Redesignated to R.S. 40:1133.1 by HCR 84 of 2015 R.S.

RS 40:1232 - Redesignated to R.S. 40:1133.1 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1232.1. Redesignated to R.S. 40:1133.2 by HCR 84 of 2015 R.S.

RS 40:1232.1 - Redesignated to R.S. 40:1133.2 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1232.2. Redesignated to R.S. 40:1133.3 by HCR 84 of 2015 R.S.

RS 40:1232.2 - Redesignated to R.S. 40:1133.3 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1232.3. Redesignated to R.S. 40:1133.4 by HCR 84 of 2015 R.S.

RS 40:1232.3 - Redesignated to R.S. 40:1133.4 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1232.4. Redesignated to R.S. 40:1133.5 by HCR 84 of 2015 R.S.

RS 40:1232.4 - Redesignated to R.S. 40:1133.5 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1232.5. Redesignated to R.S. 40:1133.6 by HCR 84 of 2015 R.S.

RS 40:1232.5 - Redesignated to R.S. 40:1133.6 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1232.6. Redesignated to R.S. 40:1133.7 by HCR 84 of 2015 R.S.

RS 40:1232.6 - Redesignated to R.S. 40:1133.7 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1232.7. Redesignated to R.S. 40:1133.8 by HCR 84 of 2015 R.S.

RS 40:1232.7 - Redesignated to R.S. 40:1133.8 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1232.8. Redesignated to R.S. 40:1133.9 by HCR 84 of 2015 R.S.

RS 40:1232.8 - Redesignated to R.S. 40:1133.9 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1232.9. Redesignated to R.S. 40:1133.10 by HCR 84 of 2015 R.S.

RS 40:1232.9 - Redesignated to R.S. 40:1133.10 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1232.10. Redesignated to R.S. 40:1133.11 by HCR 84 of 2015 R.S.

RS 40:1232.10 - Redesignated to R.S. 40:1133.11 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1232.11. Redesignated to R.S. 40:1133.12 by HCR 84 of 2015 R.S.

RS 40:1232.11 - Redesignated to R.S. 40:1133.12 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1233. Redesignated to R.S. 40:1133.13 by HCR 84 of 2015 R.S.

RS 40:1233 - Redesignated to R.S. 40:1133.13 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1233.1. State hospitals; medical malpractice coverage

PART II. MEDICAL MALPRACTICE COVERAGE
§1233.1. State hospitals; medical malpractice coverage
Each state owned or state operated hospital in Louisiana may provide medical malpractice coverage to medical doctors, dentists and professional nurses who are employed by such hospital or who donate services free of charge to such hospital or who have personal services contracts with such hospital to provide medical services. Such coverage shall only apply to those claims arising from services rendered by such medical doctors, dentists or professional nurses as a direct result of such employment, donation of services or contract for services. For the purposes of this Part the term "medical doctor" shall mean any person holding a valid certificate to practice medicine issued pursuant to R.S. 37:1273; the term "dentist" shall mean any person holding a valid certificate to practice dentistry issued pursuant to R.S. 37:751 through R.S. 37:763; the term "professional nurse" shall mean any person holding a valid certificate to practice nursing pursuant to R.S. 37:921, R.S. 37:971 or R.S. 37:972.
Added by Acts 1975, No. 477, §1; Redesignated from R.S. 40:1299.37 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1234. Redesignated to R.S. 40:1133.14 by HCR 84 of 2015 R.S.

RS 40:1234 - Redesignated to R.S. 40:1133.14 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1234.1. Redesignated to R.S. 40:1133.15 by HCR 84 of 2015 R.S.

RS 40:1234.1 - Redesignated to R.S. 40:1133.15 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1235. Redesignated to R.S. 40:1135.1 by HCR 84 of 2015 R.S.

RS 40:1235 - Redesignated to R.S. 40:1135.1 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1235.1. State agency may provide malpractice coverage

RS 40:1235.1 - State agency may provide malpractice coverage
Each agency of the state which employs physicians, dentists or professional nurses to provide medical services for or on behalf of such agency and each agency of the state to whom any medical doctor, dentist or professional nurse donates their services may provide such persons with medical malpractice coverage at no cost to such persons. For the purposes of this Part the term "physician" shall mean any person holding a valid certificate to practice medicine issued pursuant to R.S. 37:1273; the term "dentist" shall mean any person holding a valid certificate to practice dentistry issued pursuant to R.S. 37:751 through R.S. 37:763; the term "professional nurse" shall mean any person holding a valid certificate to practice nursing pursuant to R.S. 37:921, R.S. 37:971 or R.S. 37:972. The coverage provided for herein shall apply only to those actions arising from services rendered as a direct result of such employment or donation.
Added by Acts 1975, No. 674, §1; Redesignated from R.S. 40:1299.38 by HCR 84 of 2015 R.S.
NOTE: Former R.S. 40:1235.1 redesignated to R.S. 40:1135.2 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1235.2. Redesignated to R.S. 40:1135.3 by HCR 84 of 2015 R.S.

RS 40:1235.2 - Redesignated to R.S. 40:1135.3 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1235.3. Redesignated to R.S. 40:1135.4 by HCR 84 of 2015 R.S.

RS 40:1235.3 - Redesignated to R.S. 40:1135.4 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1235.4. Redesignated to R.S. 40:1135.5 by HCR 84 of 2015 R.S.

RS 40:1235.4 - Redesignated to R.S. 40:1135.5 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236. Redesignated to R.S. 40:1135.6 by HCR 84 of 2015 R.S.

RS 40:1236 - Redesignated to R.S. 40:1135.6 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.1. Redesignated to R.S. 40:1135.7 by HCR 84 of 2015 R.S.

RS 40:1236.1 - Redesignated to R.S. 40:1135.7 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.2. Redesignated to R.S. 40:1135.8 by HCR 84 of 2015 R.S.

RS 40:1236.2 - Redesignated to R.S. 40:1135.8 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.4. Redesignated to R.S. 40:1135.9 by HCR 84 of 2015 R.S.

RS 40:1236.4 - Redesignated to R.S. 40:1135.9 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.5. Redesignated to R.S. 40:1135.10 by HCR 84 of 2015 R.S.

RS 40:1236.5 - Redesignated to R.S. 40:1135.10 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.6. Redesignated to R.S. 40:1135.11 by HCR 84 of 2015 R.S.

RS 40:1236.6 - Redesignated to R.S. 40:1135.11 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.7. Redesignated to R.S. 40:1135.12 by HCR 84 of 2015 R.S.

RS 40:1236.7 - Redesignated to R.S. 40:1135.12 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.11. Redesignated to R.S. 40:1137.1 by HCR 84 of 2015 R.S.

RS 40:1236.11 - Redesignated to R.S. 40:1137.1 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.12. Redesignated to R.S. 40:1137.2 by HCR 84 of 2015 R.S.

RS 40:1236.12 - Redesignated to R.S. 40:1137.2 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.13. Redesignated to R.S. 40:1137.3 by HCR 84 of 2015 R.S.

RS 40:1236.13 - Redesignated to R.S. 40:1137.3 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.14. Redesignated to R.S. 40:1137.4 by HCR 84 of 2015 R.S.

RS 40:1236.14 - Redesignated to R.S. 40:1137.4 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.21. Redesignated to R.S. 40:1139.1 by HCR 84 of 2015 R.S.

RS 40:1236.21 - Redesignated to R.S. 40:1139.1 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.22. Redesignated to R.S. 40:1139.2 by HCR 84 of 2015 R.S.

RS 40:1236.22 - Redesignated to R.S. 40:1139.2 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.23. Redesignated to R.S. 40:1139.3 by HCR 84 of 2015 R.S.

RS 40:1236.23 - Redesignated to R.S. 40:1139.3 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.24. Redesignated to R.S. 40:1139.4 by HCR 84 of 2015 R.S.

RS 40:1236.24 - Redesignated to R.S. 40:1139.4 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.25. Redesignated to R.S. 40:1139.5 by HCR 84 of 2015 R.S.

RS 40:1236.25 - Redesignated to R.S. 40:1139.5 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.27. Redesignated to R.S. 40:1139.7 by HCR 84 of 2015 R.S.

RS 40:1236.27 - Redesignated to R.S. 40:1139.7 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.28. Redesignated to R.S. 40:1139.8 by HCR 84 of 2015 R.S.

RS 40:1236.28 - Redesignated to R.S. 40:1139.8 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.29. Redesignated to R.S. 40:1139.9 by HCR 84 of 2015 R.S.

RS 40:1236.29 - Redesignated to R.S. 40:1139.9 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.30. Redesignated to R.S. 40:1139.10 by HCR 84 of 2015 R.S.

RS 40:1236.30 - Redesignated to R.S. 40:1139.10 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1236.31. Redesignated to R.S. 40:1139.11 by HCR 84 of 2015 R.S.

RS 40:1236.31 - Redesignated to R.S. 40:1139.11 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1237. Redesignated to R.S. 40:1060.11 by HCR 84 of 2015 R.S.

RS 40:1237 - Redesignated to R.S. 40:1060.11 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1237.3. Medical review panel; one panel for state and private claims

RS 40:1237.3 - Medical review panel; one panel for state and private claims
The following provisions shall apply when, for the same injury to or death of a patient, a malpractice claim alleges liability of both a state health care provider under the provisions of this Part and a health care provider under the provisions of Part I of this Subchapter:
(1) Unless all parties have agreed otherwise, only one medical review panel shall be convened in such instance to review the claims under this Part and Part I of this Subchapter.
(2) The panel shall consist of a single attorney chairperson and three health care providers who hold unlimited licenses to practice their profession in Louisiana.
(3) The panel shall be considered a joint medical review panel, and its actions shall be deemed to have the same force and effect as if a separate medical review panel had been convened under each of the respective Parts.
(4) The panel shall be governed by the law applicable under both Parts. In the event of a procedural conflict between the provisions of the Parts, the provisions of R.S. 40:1231.8 shall govern.
Acts 2004, No. 183, §1, eff. June 10, 2004; Redesignated from R.S. 40:1299.39.2 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1238. Redesignated to R.S. 40:1060.12 by HCR 84 of 2015 R.S.

RS 40:1238 - Redesignated to R.S. 40:1060.12 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1238.1. Redesignated to R.S. 40:1060.13 by HCR 84 of 2015 R.S.

RS 40:1238.1 - Redesignated to R.S. 40:1060.13 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1238.2. Redesignated to R.S. 40:1060.14 by HCR 84 of 2015 R.S.

RS 40:1238.2 - Redesignated to R.S. 40:1060.14 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1238.3. Redesignated to R.S. 40:1060.15 by HCR 84 of 2015 R.S.

RS 40:1238.3 - Redesignated to R.S. 40:1060.15 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1238.4. Redesignated to R.S. 40:1060.16 by HCR 84 of 2015 R.S.

RS 40:1238.4 - Redesignated to R.S. 40:1060.16 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1239. Redesignated to R.S. 40:1060.21 by HCR 84 of 2015 R.S.

RS 40:1239 - Redesignated to R.S. 40:1060.21 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1241. Hospital prospective reimbursement methodology

RS 40:1241 - Hospital prospective reimbursement methodology
A. Notwithstanding any provisions of the Louisiana Administrative Code or any contrary provision of any other law or regulation, for the purpose of the hospital prospective reimbursement methodology and temporary licensure of international medical graduates, the Louisiana Medical Assistance Program's recognition of a major teaching hospital is limited to facilities having a documented affiliation agreement with a Louisiana medical school accredited by the Liaison Committee on Medical Education or the Commission on Osteopathic College Accreditation.
B. A major teaching hospital shall meet one of the following criteria:
(1) Be a major participant in at least four approved medical residency programs of which at least two of the programs shall be in medicine, surgery, obstetrics and gynecology, pediatrics, family practice, emergency medicine, or psychiatry.
(2) Maintain an intern and resident full-time equivalency of at least twenty filled positions with an approved medical residency program in family practice located more than one hundred fifty miles from the medical school accredited by the Liaison Committee on Medical Education.
C. For the purposes of this Subpart, "hospital prospective reimbursement methodology" means a method of hospital reimbursement in which Medicaid payment is made based on a predetermined, fixed amount.
NOTE: §1241 repealed effective only upon implementation of a diagnosis-related group hospital payment methodology pursuant to an approved state plan amendment by the Centers for Medicare and Medicaid Services.
RS 40:1241 - Repealed by Acts 2018, No. 234, §1.
Acts 2009, No. 347, §1; Redesignated from R.S. 40:1300.291 by HCR 84 of 2015 R.S; Acts 2018, No. 234, §1; Acts 2022, No. 152, §1.
NOTE: Former R.S. 40:1241 redesignated to R.S. 40:1265.1 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1243.1. Healthcare providers; upper payment limit

RS 40:1243.1 - Healthcare providers; upper payment limit
A. Subject to appropriation, the Louisiana Department of Health may develop and maintain a Medicaid upper payment limit financing methodology which incorporates any healthcare provider licensed by the Louisiana Department of Health. The purpose of developing an upper payment limit financing methodology is to enhance the delivery of healthcare services to the uninsured and Medicaid patients. Any such upper payment limit financing methodology shall be in accordance with federal law and subject to approval by the Centers for Medicare and Medicaid Services.
B. The department may submit waivers or state plan amendments to the Centers for Medicare and Medicaid Services in order to secure federal financial participation in relation to any such upper payment limit financing methodology. Disbursements of monies generated by the use of an upper payment limit methodology shall be made only in accordance with an approved waiver or state plan amendment.
Acts 2011, No. 310, §1, eff. June 28, 2011; Redesignated from R.S. 40:1300.331 by HCR 84 of 2015 R.S; Acts 2018, No. 206, §4.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1243.2. Upper payment limit mechanism for outpatient behavioral health services for Medicaid recipients under the age of twenty-one

RS 40:1243.2 - Upper payment limit mechanism for outpatient behavioral health services for Medicaid recipients under the age of twenty-one
A. The Louisiana Department of Health is authorized to seek approval from the Centers for Medicare and Medicaid Services of a program designed to reimburse non-state, governmental entities through the Medicaid program for outpatient behavioral health services to Medicaid recipients under the age of twenty-one.
B. The Louisiana Department of Health may develop and maintain a Medicaid upper payment limit financing methodology for the behavioral health services provided for in Subsection A of this Section. The disbursements of monies generated by the use of an upper payment limit methodology shall be made only in accordance with an approved waiver or state plan amendment. The source of the non-federal match for these payments may only be by voluntary certification of expenditures or intergovernmental transfer of funds.
Acts 2012, No. 650, §1, eff. June 7, 2012; Redesignated from R.S. 40:1300.332 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1243.3. Upper payment limit mechanism for ambulatory surgical centers

RS 40:1243.3 - Upper payment limit mechanism for ambulatory surgical centers
A. The Louisiana Department of Health is authorized to seek approval from the Centers for Medicare and Medicaid Services of a program designed to reimburse ambulatory surgical centers that have an agreement with a governmental entity or entities to provide enhanced Medicaid services.
B. The Louisiana Department of Health may develop and maintain a Medicaid upper payment limit financing methodology for ambulatory surgical centers provided for in Subsection A of this Section. The disbursements of money generated by the use of an upper payment limit methodology shall be made only in accordance with an approved waiver or state plan amendment. The source of the nonfederal match for these payments may only be by voluntary certification of expenditures or intergovernmental transfer of funds.
Acts 2014, No. 494, §1, eff. June 5, 2014; Redesignated from R.S. 40:1300.333 by HCR 84 of 2015 R.S; Acts 2018, No. 206, §4.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1244.1. Physician upper payment limit methodology

RS 40:1244.1 - Physician upper payment limit methodology
The Louisiana Department of Health is hereby authorized to develop mechanisms to support the continued operation of state-funded healthcare programs, specifically Medicaid, through the utilization of physician upper payment limit reimbursement methodologies. Any such methodology utilized shall be designed to continue access and delivery of healthcare services to the poor. The implementation of this methodology shall be subject to federal law and approval by the Centers for Medicare and Medicaid Services. Participation in the utilization of physician upper payment limit reimbursement methodologies shall be limited exclusively to hospitals which certify public expenditures to the state.
Acts 2010, No. 434, §1, eff. June 22, 2010; Acts 2022, No. 271, §§5, 9C; Redesignated from R.S. 46:2891.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1245.1. Authority to accept and use intergovernmental transfers from local governing bodies

RS 40:1245.1 - Authority to accept and use intergovernmental transfers from local governing bodies
A. The Louisiana Department of Health may accept intergovernmental transfers from local governing bodies, including but not limited to a parish, for the purpose of enhancing the delivery of health care services to the uninsured and Medicaid patients. Any such transfer shall be in accordance with federal law and subject to approval by the Centers for Medicare and Medicaid Services.
B. It is the intent of the legislation that any transfer authorized herein shall be primarily utilized for the enhancement of health care within the jurisdiction of the transferring entity. However, any such transfer shall be under the administrative control of the Louisiana Department of Health.
C. The department may establish a methodology utilizing a pool, or pools, to facilitate distribution of any transfers received in addition to any federal financial participation earned through the use of such transfers, as authorized herein. The methodology shall be created with the intent to maximize, to the fullest extent possible, the return to the providers located within the jurisdiction of the local governing body from which such transfer is derived. The department may create criteria for qualification to participate in any pool methodology and establish criteria and priorities for reimbursement within the respective pool. Any such criteria may include health care providers which reside outside the jurisdiction of the transferring body.
D. The department may submit waivers or state plan amendments to the Centers for Medicare and Medicaid Services in order to secure federal financial participation in relation to any such payments or reimbursement. Payments shall be made only in accordance with an approved waiver or state plan amendment.
E. The department and the transferring local governing body may enter into an agreement, in accordance with state and federal law, concerning the use of transferred funds in a way that is consistent with the legislative intent set forth herein.
Acts 2009, No. 372, §1; Redesignated from R.S. 40:1300.301 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1247.1. Funding identification

RS 40:1247.1 - Funding identification
All parish and municipal entities are hereby authorized to identify funds received from any source other than the state and to consult with the Louisiana Department of Health in an effort to maximize revenues for both the Louisiana Department of Health and the parish and municipal entities. Collaboration between the Louisiana Department of Health and the parish and municipal entities may allow such entities to receive additional funding from public and private sources. The provisions of this Subpart shall not be construed to require any parish or municipal entity to enter into an agreement with the Louisiana Department of Health.
Acts 2012, No. 360, §1, eff. May 31, 2012; Redesignated from R.S. 40:1300.351 by HCR 84 of 2015 R.S.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1248.1. Definitions

RS 40:1248.1 - Definitions
As used in this Subpart, the following terms have the meaning ascribed to them in this Section:
(1) "Department" means the Louisiana Department of Health.
(2) "Governmental institutional provider" means either of the following:
(a) A nonstate governmental hospital, licensed in accordance with the Hospital Licensing Law, R.S. 40:2100 et seq., other than a rural hospital as defined in R.S. 40:1189.3.
(b) A hospital included in the definition of public, nonrural community hospital as defined in the Louisiana Medicaid State Plan.
(3) "Institutional provider" means a nongovernmental hospital licensed in accordance with the Hospital Licensing Law, R.S. 40:2100 et seq.
(4) "Paying hospital" means an institutional provider required by the provisions of this Subpart to make a local hospital assessment payment.
(5) "Program" means the local healthcare provider participation program authorized by this Subpart.
(6) "Rural institutional provider" means a hospital, other than one defined in R.S. 40:1189.3, that is licensed by the department, has no more than sixty hospital beds on November 1, 2020, and meets any of the following criteria:
(a) Is located in a municipality with a population of not less than seven thousand persons and not more than seven thousand five hundred persons according to the most recent federal decennial census and in a parish with a population of not less than thirty thousand persons and not more than thirty-five thousand persons according to the most recent federal decennial census.
(b) Is located in a municipality with a population of not less than ten thousand persons and not more than ten thousand five hundred persons according to the most recent federal decennial census and in a parish with a population of not less than eighty thousand persons and not more than ninety thousand persons according to the most recent federal decennial census.
(c) Is located in a municipality with a population of not less than three thousand persons and not more than three thousand five hundred persons according to the most recent federal decennial census and in a parish with a population of not less than thirty thousand persons and not more than thirty-five thousand persons according to the most recent federal decennial census.
Acts 2020, No. 330, §1.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1248.2. Purpose

RS 40:1248.2 - Purpose
The purpose of this Subpart is to generate revenue by collecting from certain institutional providers a local hospital assessment payment to be used to provide the nonfederal share of a Medicaid payment program directly benefitting the residents of a parish.
Acts 2020, No. 330, §1.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1248.3. Applicability

RS 40:1248.3 - Applicability
The provisions of this Subpart shall apply exclusively to the following parishes:
(1) Any parish with a population of not less than forty thousand persons and not more than forty-two thousand persons according to the most recent federal decennial census.
(2) Any parish with a population of not less than forty-six thousand persons and not more than forty-seven thousand persons according to the most recent federal decennial census.
(3) Any parish in which a rural institutional provider is located.
Acts 2020, No. 330, §1.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1248.4. Parish healthcare provider participation program

RS 40:1248.4 - Parish healthcare provider participation program
A. The legislature hereby creates a local healthcare provider participation program through which a parish may deposit in a local provider participation fund established by the parish all of the following monies:
(1) Any local hospital assessment payment from an institutional provider located in the parish.
(2) Such other sums as the parish deems appropriate.
B. Monies in the provider participation fund may be used by the parish to fund certain intergovernmental transfers and indigent care programs as provided by this Subpart.
C. A parish may adopt an ordinance authorizing it to participate in the program, subject to the limitations provided in this Subpart.
D. Any parishes authorized by R.S. 40:1248.3 to establish a local provider participation fund may, upon agreement of the governing authorities of each parish, establish a single fund for the benefit of those parishes and a local hospital assessment applicable to the institutional providers in those parishes.
Acts 2020, No. 330, §1.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1248.5. Powers and duties of parishes; limitations; inspection of provider records

RS 40:1248.5 - Powers and duties of parishes; limitations; inspection of provider records
A. The governing body of a parish may require a local hospital assessment payment authorized by this Subpart from an institutional provider in the parish. The requirement for payment shall be implemented in the manner provided for in this Section.
B. A parish may authorize the collection of a local hospital assessment payment authorized by this Subpart only with an affirmative vote of a majority of the members of the governing body of the parish made at a regular or special meeting held no less than thirty days following publication of a notice in the official journal of the parish of intention to authorize the collection of such payment.
C.(1) A parish that collects a local hospital assessment payment authorized by this Subpart shall require each institutional provider to submit to the parish a copy of any financial and utilization data required by and reported to the department.
(2) A parish that collects a local hospital assessment payment authorized by this Subpart may inspect the records of an institutional provider to the extent necessary to ensure compliance with the requirements of Paragraph (1) of this Subsection.
Acts 2020, No. 330, §1.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1248.6. Public hearings

RS 40:1248.6 - Public hearings
A. Any parish that collects a local hospital assessment payment authorized by this Subpart shall hold an annual public hearing on the amounts of any local hospital assessment payments that the parish intends to require during the year and how the revenue derived from those payments is to be spent.
B. Not later than the tenth day before the date of the hearing required by Subsection A of this Section, the parish governing authority shall publish notice of the hearing in the official journal of the parish. A representative of a paying hospital shall be entitled to appear at the time and place designated in the public notice and to be heard regarding any matter related to the local hospital assessment payments authorized by this Subpart.
Acts 2020, No. 330, §1.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1248.7. Local provider participation fund; authorized uses

RS 40:1248.7 - Local provider participation fund; authorized uses
A. Each parish that collects a local hospital assessment payment authorized by this Subpart or in which a rural institutional provider is located shall create a local provider participation fund. All income received by a parish pursuant to the provisions of this Subpart, including the revenue from local hospital assessment payments remaining after discounts and fees for assessing and collecting the payments are deducted, shall be deposited in the local provider participation fund of the parish. Monies in the fund may be withdrawn only in accordance with and for purposes specified in the provisions of this Section.
B. The local provider participation fund of a parish shall consist of the following monies:
(1) All revenue received by the parish attributable to local hospital assessment payments authorized by this Subpart, including any penalties and interest attributable to delinquent payments.
(2) Monies received from the department as a refund of an intergovernmental transfer from the parish to the state for the purpose of providing the nonfederal share of Medicaid base rate payments, provided that the intergovernmental transfer does not receive a federal matching payment.
(3) Sums which the parish elects to deposit.
(4) The earnings of the fund.
C. Monies in the local provider participation fund may be used only for one or more of the following purposes:
(1) To fund intergovernmental transfers from a parish to the state to provide the nonfederal share of a program of Medicaid payments for the benefit of rural institutional providers or other hospitals in the parish authorized under the Medicaid state plan.
(2) To pay the administrative expenses of a parish associated exclusively with activities authorized by this Subpart in an amount not to exceed five percent of the local hospital assessment payment.
(3) To refund a portion of a local hospital assessment payment collected in error from a paying hospital.
(4) To refund to paying hospitals the proportionate share of money received by a parish from the department that is not used to fund the nonfederal share of Medicaid payment program payments described in Paragraph (1) of this Subsection.
D. Money in the local provider participation fund shall not be commingled with other parish funds.
Acts 2020, No. 330, §1.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1248.8. Local hospital assessment payments; basis; calculation

RS 40:1248.8 - Local hospital assessment payments; basis; calculation
A. Except as provided in Subsection E of this Section, a parish that collects a local hospital assessment payment authorized by this Subpart may require an annual local hospital assessment payment to be assessed quarterly on the net patient revenue of each institutional provider located in the parish. In the first year in which the local hospital assessment payment is required, the local hospital assessment payment shall be assessed on the net patient revenue of an institutional provider as determined by the most recently filed Medicaid cost report. The parish shall update the amount of the local hospital assessment payment on an annual basis.
B. The amount of a local hospital assessment payment authorized by this Subpart shall be uniformly proportionate with the amount of net patient revenue generated by each paying hospital in the parish. In accordance with 42 U.S.C. 1396b(w), a local hospital assessment payment authorized by this Subpart shall not hold harmless any institutional provider.
C. A parish that collects a local hospital assessment payment authorized by this Subpart shall set the amount of the local hospital assessment payment. The amount of the local hospital assessment payment required of each paying hospital may not exceed an amount that, when added to the amount of the local hospital assessment payments required from all other paying hospitals in the parish, and the amount of any assessment, local hospital assessment payment, or tax imposed by the state, equals an amount of revenue that exceeds six percent of the aggregate net patient revenue of all paying hospitals in the parish.
D. Subject to the maximum payment amount prescribed in Subsection C of this Section, a parish that collects a local hospital assessment payment authorized by this Subpart shall set local hospital assessment payments in amounts that in the aggregate will generate sufficient revenue to cover the administrative expenses of the parish for activities provided for in this Subpart and to fund the nonfederal share of a Medicaid base rate payment; except that the amount of revenue from local hospital assessment payments used for administrative expenses of the parish for activities provided for in this Subpart in a year may not exceed five percent of the total revenue generated from the local hospital assessment payment or twenty thousand dollars, whichever is greater.
E. A paying hospital may not add a local hospital assessment payment required by this Section as a surcharge to a patient.
Acts 2020, No. 330, §1.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1248.9. Local hospital assessment payments; collection

RS 40:1248.9 - Local hospital assessment payments; collection
The sheriff of a parish shall collect the local hospital assessment payment authorized by this Subpart. The sheriff shall charge and deduct from local hospital assessment payments collected for the parish a fee for collecting those payments in an amount determined by the parish. The fee shall not exceed the usual and customary charges imposed by the sheriff.
Acts 2020, No. 330, §1.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1248.10. Eligibility of funds for federal match; conformance with requirements of federal Medicaid agency

RS 40:1248.10 - Eligibility of funds for federal match; conformance with requirements of federal Medicaid agency
To the extent that any provision of this Subpart or procedure established in accordance with this Subpart causes a local hospital assessment payment authorized by this Subpart to be ineligible for federal matching funds, the parish may provide by rule for an alternative provision or procedure that conforms to the requirements of the Centers for Medicare and Medicaid Services.
Acts 2020, No. 330, §1.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1248.11. Rural institutional providers; enhanced reimbursement

RS 40:1248.11 - Rural institutional providers; enhanced reimbursement
A. Upon request from a parish in which a rural institutional provider is located, the department shall attempt in good faith to execute a cooperative endeavor agreement for the use of local provider participation fund proceeds. Notwithstanding any law to the contrary, by September 1, 2020, or as soon thereafter as such a cooperative endeavor agreement is effective, the department shall file a Medicaid state plan amendment with the Centers for Medicare and Medicaid Services, referred to hereafter in this Section as "CMS", amending the Medicaid state plan provisions governing hospital reimbursement to provide that a rural institutional provider, as defined in R.S. 40:1248.1, shall be reimbursed at a rate which equals or approximates one hundred ten percent, or, if a reduction is required by CMS, the maximum amount acceptable to CMS, but in no case less than one hundred percent, of the appropriate reasonable cost of providing hospital inpatient and outpatient services, including but not limited to services provided in a rural health clinic licensed as part of a rural hospital. The new rural hospital payment methodology shall utilize prospective rates approximating costs at the time of service for inpatient acute care and psychiatric services. To ensure that rural hospital outpatient services, including those reimbursed on a cost basis and those reimbursed on a fee schedule, are reimbursed in the aggregate at one hundred ten percent of the reasonable costs or such lesser amounts as approved by CMS, but in no case less than one hundred percent of their reasonable costs, the department shall pay an interim rate for cost-based outpatient services at one hundred ten percent of reasonable cost during the year and for fee-based services paid on a claim-by-claim basis, and the department shall make quarterly estimates of Medicaid base rate payments required to bring reimbursement to the hospital for such services up to one hundred percent of reasonable costs and immediately remit such payments to the hospital, and at final settlement pay such amounts as are necessary to ensure that all outpatient services in the aggregate, both cost-based and fee schedule, are paid at one hundred ten percent of reasonable costs.
B. The rural institutional provider payment methodology provided for in this Subpart shall be implemented on January 1, 2021, or as soon thereafter as is practicable after such methodology is authorized by federal law.
Acts 2020, No. 330, §1.
2023 Louisiana Laws › Revised Statutes › Title 40 - Public Health and Safety › §40:1248.12. Governmental institutional providers; enhanced reimbursement

RS 40:1248.12 - Governmental institutional providers; enhanced reimbursement
A. Upon request from a parish in which a governmental institutional provider is located, the department shall attempt in good faith to execute a cooperative endeavor agreement acceptable to the department. Notwithstanding any law to the contrary, by September 1, 2020, or as soon thereafter as such a cooperative endeavor agreement is effective, the department shall file a Medicaid state plan amendment with the Centers for Medicare and Medicaid Services, referred to hereafter in this Section as "CMS", amending the Medicaid state plan provisions governing hospital reimbursement to provide that a governmental institutional provider, as defined in R.S. 40:1248.1, shall be reimbursed at a rate which equals or approximates one hundred ten percent, or, if a reduction is required by CMS, the maximum amount acceptable to CMS, but in no case less than one hundred percent, of the appropriate reasonable cost of providing hospital inpatient and outpatient services, including but not limited to services provided in a rural health clinic licensed as part of a governmental institutional provider. The new governmental institutional provider payment methodology shall utilize prospective rates approximating costs at the time of service for inpatient acute care and psychiatric services. To ensure that governmental institutional provider outpatient services, including those reimbursed on a cost basis and those reimbursed on a fee schedule, are reimbursed in the aggregate at one hundred ten percent of the reasonable costs or such lesser amounts as approved by CMS, but in no case less than one hundred percent of their reasonable costs, the department shall pay an interim rate for cost-based outpatient services at one hundred ten percent of reasonable cost during the year and for fee-based services paid on a claim-by-claim basis, and the department shall make quarterly estimates of Medicaid base rate payments required to bring reimbursement to the governmental institutional provider for such services up to one hundred percent of reasonable costs and immediately remit such payments to the governmental institutional provider, and at final settlement pay such amounts as are necessary to ensure that all outpatient services in the aggregate, both cost-based and fee schedule, are paid at one hundred ten percent of reasonable costs.
B. The governmental institutional provider payment methodology provided for in this Subpart shall be implemented on January 1, 2021, or as soon thereafter as is practicable after the methodology is authorized by federal law.
Acts 2020, No. 330, §1.