1. 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).

2. B. Methodology

   1. 1. Payment will be based on each provider’s specific pro-rated share of an additional dedicated program funding pool totaling $4,665,635.
   2. 2. The pro-rated share for each provider will be determined utilizing the provider’s 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. 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. 4. The one-time payment will be made on or before June 30, 2020.
   5. 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).

3. 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. 1. Methodology

      1. a. Payment will be based on each provider’s specific pro-rated share of an additional dedicated program funding pool totaling $27,974,178.
      2. 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.
      3. 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.
      4. d. The one-time payment will be made on or before June 30, 2023.
      5. e. All facilities receiving payment shall be open and operating as an ICF/IID at the time the payment is made.
      6. 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).

4. D. Effective for providers, active and Medicaid certified as of July 1, 2024, a one-time lump sum payment will be made to non-state, non-public ICFs/IID.

   1. 1. Methodology

      1. a. Payment will be based on each provider’s specific prorated share of an additional dedicated program funding pool. This payment shall not exceed $31,000,000.
      2. b. The prorated share for each provider will be determined utilizing the provider’s percentage of program Medicaid days for dates of service within a period of three consecutive months selected by the department, occurring between January 1, 2024, and December 31, 2024.
      3. c. If the additional dedicated program funding pool lump sum payment exceeds 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.D.1.b above.
      4. d. Payment of the one-time, lump sum payment is subject to approval by the CMS.

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, Bureau of Health Services Financing, LR 46:28 (January 2020), amended LR 48:2972 (December 2022), LR 51:667 (May 2025), LR 52:497 (April 2026).