Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part V - Hospital Services › Subpart 5 - Outpatient Hospital Services › Chapter 57 - Laboratory Services › Subchapter B - Reimbursement Methodology › Section V-5719 - Childrens Specialty Hospitals

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Effective for dates of service on or after September 1, 2009, the reimbursement
					 amount paid to children's specialty hospitals for outpatient clinical
					 diagnostic laboratory services shall be the Medicaid fee schedule amount on
					 file for each service.
B. Effective
					 for dates of service on or after February 3, 2010, the reimbursement paid to
					 children's specialty hospitals for outpatient clinical diagnostic laboratory
					 services shall be reduced by five percent of the fee schedule on file as of
					 February 2, 2010.
C. Effective for
					 dates of service on or after August 1, 2010, the reimbursement paid to
					 non-rural, non-state hospitals for outpatient clinical diagnostic laboratory
					 services shall be reduced by 4.6 percent of the fee schedule on file as of July
					 31, 2010.
D. Effective for dates of
					 service on or after January 1, 2011, the reimbursement paid to non-rural,
					 non-state hospitals for outpatient clinical diagnostic laboratory services
					 shall be reduced by 2 percent of the fee schedule on file as of December 31,
					 2010.
E. Effective for dates of
					 service on or after August 1, 2012, the reimbursement rates paid to children's
					 specialty hospitals for outpatient clinical diagnostic laboratory services
					 shall be reduced by 3.7 percent of the fee schedule on file as of July 31,
					 2012.
F. Effective for dates of
					 service on or after February 1, 2013, the reimbursement rates paid to
					 children's specialty hospitals for outpatient clinical diagnostic laboratory
					 services shall be reduced by 1 percent of the fee schedule on file as of
					 January 31, 2013.
G. Effective for
					 dates of service on or after January 1, 2017, the reimbursement rates paid to
					 childrens specialty hospitals for outpatient clinical diagnostic laboratory
					 services shall be increased by 7.03 percent of the rates on file as of December
					 31, 2016.
H. Effective for dates of
					 service on or after January 1, 2018, the reimbursement rates paid to children's
					 specialty hospitals for outpatient clinical diagnostic laboratory services
					 shall be increased by 4.82 percent of the rates on file as of December 31,
					 2017.
I. Effective for dates of
					 service on or after January 1, 2019, the reimbursement rates paid to childrens
					 specialty hospitals for outpatient clinical diagnostic laboratory services
					 shall be increased by 5.26 percent of the rates on file as of December 31,
					 2018.
1. In accordance with
					 Section
					 1903(i)(7) of
					 the Social Security Act, payments for Medicaid clinical diagnostic laboratory
					 services shall be limited to the amount that Medicare pays on a per test basis.
					 If this or any other rate adjustment causes the Medicaid calculated rate to
					 exceed the Medicare payment rate for a clinical laboratory test, the rate shall
					 be adjusted to the lower Medicare payment rate.