La. Admin. Code tit. 50 § VII-32917
Current through Register Vol. 50, No. 11, November 20, 2024
Section VII-32917 - Dedicated Program Funding Pool PaymentsA. 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).B. Methodology 1. Payment will be based on each providers specific pro-rated share of an additional dedicated program funding pool totaling $4,665,635.2. The pro-rated share for each provider will be determined utilizing the providers 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. 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. The one-time payment will be made on or before June 30, 2020.5. 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).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. Methodology a. Payment will be based on each provider's specific pro-rated share of an additional dedicated program funding pool totaling $27,974,178.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.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.d. The one-time payment will be made on or before June 30, 2023.e. All facilities receiving payment shall be open and operating as an ICF/IID at the time the payment is made.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).La. Admin. Code tit. 50, § VII-32917
Promulgated by the Department of Health, Bureau of Health Services Financing, LR 43663 (4/1/2017), Repealed LR 44608 (3/1/2018), Promulgated by the Department of Health, Bureau of Health Services Financing, LR 4628 (1/1/2020), Amended LR 482065, Promulgated by the Department of Health, Bureau of Health Services Financing, LR 46:28 (January 2020, amended LR 482972 (12/1/2022).AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.