2009 Louisiana Laws TITLE 46 Public welfare and assistance :: RS 46:2691 Medicaid trust fund for the elderly

CHAPTER 54.  MEDICAID TRUST FUND FOR THE ELDERLY

§2691.  Medicaid Trust Fund for the Elderly

A.  There is hereby established as a permanent trust fund in the state treasury designated the "Medicaid Trust Fund for the Elderly", hereinafter referred to as the "fund".  After allocation of money to the Bond Security and Redemption Fund as provided in Article VII, Section 9(B) of the Constitution of Louisiana, the treasurer shall deposit in and credit to the fund all money which is received as a result of the intergovernmental transfer program provided for in this Chapter and all income on investment of monies in the fund. Monies in the fund shall be invested by the treasurer in the manner hereinafter provided.  All unencumbered and unexpended monies in the fund at the end of the fiscal year shall remain in the fund.  Monies in the fund may be used as the source of state matching funds for Medicaid funds to make enhanced payments to local government-owned health care facilities.

B.(1)  The principal in the fund shall not be subject to appropriation, except to provide for:

(a)  The re-basing of nursing homes in accordance with the approved state Medicaid plan.

(b)  The development and funding of a case mix reimbursement system for the Medicaid nursing home program.

(c)  The payment of all costs of local governments for their participation in the intergovernmental transfer program.

(d)  The enhanced payment to any local government-owned health care facilities or health care programs in amounts as required by written agreements between the secretary and the local governments which are recommended by the Intergovernmental Transfer Subcommittee created and established in R.S. 46:2692 and approved by the governor and the Joint Legislative Committee on the Budget.

(e)  The reimbursement of the Department of Health and Hospitals for costs incurred in preparing the application for and implementing the intergovernmental transfer program established in this Chapter.

(f)  The reimbursement of any monies deposited into the fund as a result of over payments of federal funds.

(2)  Upon completion of the initial intergovernmental transfer, nursing homes will be re-based in accordance with the approved state Medicaid plan.  In ensuing years, re-basing in accordance with the approved state Medicaid plan may come from the principal in the trust, but shall be limited to earnings on investment from the fund.

(3)  Only earnings on investment from the fund may be appropriated each fiscal year for services of the state Medicaid program in the following order of priority:

(a)  For providing for a wage enhancement for direct care personnel working in Medicaid certified nursing homes in accordance with a plan established by the Department of Health and Hospitals and representatives of the nursing facility industry.  The plan shall provide for a direct pass-through of the costs of such wage enhancement in a manner to ensure that the nursing home rate is adjusted to reflect the full costs of such wage enhancement.

(b)  For appropriations solely and exclusively for services of the state Medicaid program that are subject to federal financial participation in matching funds.

(4)  Monies in the fund shall not be used to displace, replace, or supplant appropriations from the state general fund for the Medicaid program below the amount of state general fund appropriations for the Medicaid program for the 1999-2000 Fiscal Year unless the official forecast of recurring monies available for appropriation which is utilized by the legislature in its adoption of the state budget for the ensuring fiscal year as provided in R.S. 39:26 indicates that revenues for such year will be insufficient to fund the state budget at the same level as the previous year.

(5)  The state treasurer shall report the status of the fund at least quarterly to the secretary of the Department of Health and Hospitals and the Intergovernmental Transfer Subcommittee.

C.(1)  The monies deposited in and credited to the fund pursuant to Subsection A of this Section shall be invested by the state treasurer.

(2)  The state treasurer is hereby authorized and directed to invest the monies deposited in and credited to the fund that are available for investment in the investments permitted for the Louisiana Education Quality Trust Fund as set forth in R.S. 17:3803(B), (D), and (E). In establishing investment goals and policies for monies in the Medicaid Trust Fund for the Elderly, the state treasurer shall consult no less frequently than semiannually with the secretary of the Department of Health and Hospitals as to the anticipated cash withdrawals from the fund during the next twelve months.

(3)  The earnings on investment from the fund shall be available to pay expenses incurred for outside investment managers for the investment and management of the fund and for other custody, investment, and disbursement costs directly attributable to the fund, and as otherwise provided for in this Section.

(4)  Expenses attributable to the state treasurer exercising responsibility for the custody, investment, and disbursement of the monies in the fund are administrative costs properly paid out of the earnings on investment from the fund and shall be paid by appropriation from such earnings.  Such costs include those costs attributable to fees charged by any financial institution for providing custodial services, which shall not exceed two percent of the amount managed, costs incurred for outside investment managers for the investment and management of the fund, which shall not exceed two percent of the amount managed and other direct costs incurred by the treasurer.  Other costs related to the fund shall be paid by appropriation from the state general fund.  All appropriations made to, or upon the request of, the state treasurer, related to the management of the fund shall be subject to review of the Intergovernmental Transfer Subcommittee.

(5)  The provisions of this Subsection shall be subject to review and approval of the Centers for Medicare and Medicaid Services.

(6)  On or before November first of each year, the state treasurer shall prepare and submit to the secretary of the Department of Health and Hospitals a report on the performance of the fund during the prior fiscal year.  The state treasurer shall also submit a copy of the report to the Joint Legislative Committee on the Budget and to the House Committee on Health and Welfare and the Senate Committee on Health and Welfare.

Acts 2000, 1st Ex. Sess., No. 143, §1, eff. April 19, 2000; Acts 2001, No. 700, §1; Acts 2005, No. 179, §11, eff. June 28, 2005.