2009 Louisiana Laws TITLE 46 Public welfare and assistance :: RS 46:2731 Health trust fund

CHAPTER 57.  HEALTH TRUST FUND

§2731.  Health Trust Fund

A.  The "Health Trust Fund" is hereby established in the state treasury as a special fund, hereinafter referred to as the "fund".

B.  After allocation of monies to the Bond Security and Redemption Fund as provided in Article VII, Section 9(B) of the Constitution of Louisiana, the treasurer in each fiscal year shall pay into the fund an amount equal to that which is appropriated by the legislature from the sources specified in Subsection C of this Section and all interest income on investment of monies in the fund.  Monies in the fund shall be invested by the treasurer in the same manner as monies in the state general fund.  All unencumbered and unexpended monies in the fund at the end of the fiscal year shall remain in the fund.

C.  The legislature may appropriate monies to the fund from sources including but not limited to the following:

(1)  Up to, but not to exceed, one-third of earnings from the Medicaid Trust Fund for the Elderly, as authorized by R.S. 46:2691(B)(3)(b).

(2)  Monies generated from intergovernmental transfers or other permissible sources of public funds eligible as state match for federal financial participation as specified in 42 CFR 433.51.

(3)  Uncompensated care payments to state and other public providers and facilities that are designated for the purposes of intergovernmental transfer payments, except uncompensated care payments up to one hundred percent of uncompensated care costs of hospitals defined in R.S. 40:1300.143(a).

(4)  Monies contributed by local governmental units, including without limitation parishes, cities, towns, villages, and hospital service districts, and other state agencies that may be used to obtain federal matching funds under Title XIX and Title XXI of the Social Security Act and other federal programs.

D.  Appropriations from the fund shall be used and expended under the supervision of the secretary of the Department of Health and Hospitals, hereinafter referred to as the "department", and shall be restricted to the purposes of enhancing the provision of appropriate health care to Louisiana's Medicaid and LaCHIP beneficiaries and the medically indigent by:

(1)  Directing reimbursement to local providers of primary and preventive health care for the medically indigent in their communities.

(2)  Expanding eligibility for uninsured children, parents of children who are recipients of Medicaid and LaCHIP, and pregnant women, and expanding the availability of services provided to them.

(3)  Workforce development initiatives to increase access to primary and preventive health care services by supporting education and placement of physicians and other medical professionals in medically underserved areas, including but not limited to the State Loan Repayment Program, physician salary subsidies, and health education scholarships.

(4)  Initiatives to provide primary and preventive health services, including but not limited to immunizations; maternal and child health; nutritional counseling; family planning; diagnosis, management, and treatment of HIV/AIDS; diagnosis, management, and treatment of sexually transmitted diseases; women, infants, and children (WIC) nutritional services; genetic disease services; and other services as may be identified by the secretary through rules.  Notwithstanding any other provision of this Chapter to the contrary, primary and preventive health care services shall not include any functions of the department relating to environmental health such as sanitarian services, drinking water, commercial body art regulations, sanitary code mandates, disease surveillance activities, and vital records and statistics.

(5)  Funding for initiatives which increase the availability of primary care services, especially to the uninsured citizens of the state, including but not limited to providing funding to match federal grants for community health centers, funding for primary care clinics in rural hospitals, for operation of hospital service district facilities, or in medically underserved areas which treat the uninsured, and funding to integrate new and existing systems such as telemedicine and development of referral systems.

(6)  Reimbursement, to the extent allowable under state and federal law, to providers participating in the Health Trust Fund, in a manner proportionate to expenditures incurred for services provided to the indigent uninsured and taking into account for public providers, amounts transferred from the provider or their governmental authority, parish, hospital service district, or municipality, to the department.

E.(1)  Monies in the fund shall not be used to displace, replace, or supplant appropriations from the state general fund for the Medicaid program or the Children's Health Insurance Program (LaCHIP) below the amounts of state general fund appropriations for those programs for the 2001-2002 Fiscal Year.

(2)  Further, nothing contained herein shall be construed to diminish or modify the legislative commitment to rural hospitals contained in R.S. 40:1300.141 et seq., or to permit the department to reduce current Medicaid and uncompensated care payments to rural hospitals, except where such reductions are associated with decreased utilization or as otherwise required by law, by federal disallowance, or by decreased federal participation in uncompensated care payments.  Further, the department shall continue its efforts to develop new financing and reimbursement mechanisms relative to the use of Medicaid and uncompensated care payments to such rural hospitals for increased access to health care for Medicaid and LaCHIP beneficiaries and uninsured indigent individuals.

F.  Upon adoption of this Act and approval of an implementation plan in accordance with Subsection H, the secretary of the department is authorized to take any and all actions necessary to assure the continued availability of primary and preventive health care services, especially for indigent uninsured individuals, including but not limited to funding for qualifying applicants or cooperative endeavors with local government units for provision of such services.  The secretary shall require as a condition of payment of uncompensated care costs and reimbursements provided under Paragraph (D)(6) of this Section that hospitals and other health care facilities shall provide to the department patient-specific data on the amount and type of uncompensated care provided.  In addition, if a hospital or other health care facility does not provide the required patient-specific data, the secretary of the department may withhold an amount equal to five percent of Medicaid payments due that provider.  Such withholding shall increase by five percent for each successive month that the required data is not received, but the total amount withheld shall not exceed twenty-five percent of the total monthly amount due the facility.  Upon receipt of the required data, the department shall pay the facility all amounts previously withheld as a result of the failure to submit the required data.  A hospital or other health care facility subject to withholding under this provision may request an administrative review as provided by R.S. 46:437.4.  The format of the data submission shall be defined by the secretary of the department in consultation with representatives of health care facilities providing care to the indigent and uninsured.

G.  The state treasurer shall report the status of the fund at least quarterly to the secretary of the department.

H.  The provisions of this Chapter shall not be initially implemented by the department unless the following criteria have been met:

(1)  Approval of any Medicaid State Plan amendment required to implement the provisions of this Chapter by the Centers for Medicare and Medicaid Services, United States Department of Health and Human Services.

(2)  Funding is appropriated by the legislature.

(3)  Approval of an implementation plan containing cost projections for a minimum of three years that is submitted by the department to the Senate Committee on Health and Welfare, the House Committee on Health and Welfare, and the Joint Legislative Committee on the Budget.

Acts 2001, No. 491, §1, eff. June 21, 2001.