1. A. Qualifying Criteria. Effective for dates of service on or after April 15, 2013, the department shall provide supplemental Medicaid payments for outpatient hospital services rendered by non-state privately owned hospitals that meet the following conditions.

   1. 1. Qualifying Criteria. The hospital must be a non-state privately owned and operated hospital that enters into a cooperative endeavor agreement with the Department of Health and Hospitals to increase its provision of outpatient Medicaid and uninsured hospital services by:

      1. a. assuming the management and operation of services at a facility where such services were previously provided by a state owned and operated facility; or
      2. b. providing services that were previously delivered and terminated or reduced by a state owned and operated facility.

2. B. Reimbursement Methodology

   1. 1. Payments shall be made quarterly based on the annual upper payment limit calculation per state fiscal year.
   2. 2. For SFY 2013, this payment shall be $2,109,589, and for each state fiscal year starting with SFY 2014, this payment shall be $10,000,000, not to exceed the upper payment limits pursuant to 42 CFR 447.321.
   3. 3. Maximum payments shall not exceed the upper payment limit pursuant to 42 CFR 447.321.

Authority Note

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

Historical Note

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 42:407 (March 2016).