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Number 4). The April 20, 2004 Rule was amended to reduce the reimbursement rates paid through the EarlySteps Program (Part C of IDEA) for health services rendered to infants and toddlers with disabilities (Louisiana Register, Volume 31, Number 8).

During the 2008 Regular Session of the Louisiana Legislature, additional funds were allocated to increase the reimbursement rate paid for services provided to infants and toddlers with disabilities who receive services through the EarlySteps Program. As a result of the allocation of additional funds, the bureau promulgated an Emergency Rule to increase the reimbursement rate paid for certain services provided to infants and toddlers in the EarlySteps Program (Louisiana Register, Volume 34, Number 9). This proposed Rule is being promulgated to continue the provisions of the September 1, 2008 Emergency Rule.

Title 50

PUBLIC HEALTH—MEDICAL ASSISTANCE

Part XV.  Services for Special Populations

Subpart 5.  Early and Periodic Screening, Diagnoses, and Treatment

Chapter 71.Health Services

§7107.EarlySteps Reimbursement

A.EarlySteps (Part C of IDEA). The reimbursement for health services rendered to infants and toddlers with disabilities who are 0 to 3 years old shall be the lower of billed charges or 75 percent of the rate (a 25 percent reduction) in effect on January 31, 2005.

B.EarlySteps (Part C of IDEA). Effective for dates of service on or after September 1, 2008, the reimbursement for certain health services rendered in a natural environment to infants and toddlers with disabilities who are 0 to 3 years old shall be increased by 25 percent of the rate in effect on August 31, 2008.

1.For purposes of these provisions, a natural environment may include a child's home or settings in the community that are natural or normal for the child's age and peers who have no disability (i.e. childcare facility, nursery, preschool program, or playground).
2.The following services rendered in a natural environment shall be reimbursed at the increased rate:
a.occupational therapy;
b.physical therapy;
c.speech language pathology services;
d.audiology services; and
e.psychological services.

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

HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 30:800 (April 2004), amended LR 31:2030 (August 2005), LR 35:

Family Impact Statement

In compliance with Act 1183 of the 1999 Regular Session of the Louisiana Legislature, the impact of this proposed Rule on the family has been considered. It is anticipated that this proposed Rule will have a positive impact on family functioning, stability and autonomy as described in R.S. 49:972 by ensuring that families will have continued access to EPSDT services needed to maximize their child’s development.

Implementation of the provisions of this Rule shall be contingent upon the approval of the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) if it is determined that submission to CMS for review and approval is required.

Interested persons may submit written comments to Jerry Phillips, Bureau of Health Services Financing, P.O. Box 91030, Baton Rouge, LA 70821-9030. He is responsible for responding to inquiries regarding this proposed Rule. A public hearing on this proposed Rule is scheduled for Tuesday, November 25, 2008 at 9:30 a.m. in Room 118, Bienville Building, 628 North Fourth Street, Baton Rouge, LA. At that time all interested persons will be afforded an opportunity to submit data, views or arguments either orally or in writing. The deadline for receipt of all written comments is 4:30 p.m. on the next business day following the public hearing.

Alan Levine

Secretary

FISCAL AND ECONOMIC IMPACT STATEMENT FOR ADMINISTRATIVE RULES

RULE TITLE:  EarlySteps Reimbursement Rate Increase

I.ESTIMATED IMPLEMENTATION COSTS (SAVINGS) TO STATE OR LOCAL GOVERNMENT UNITS (Summary)

It is anticipated that the implementation of this proposed rule will result in an estimated increase in expenses to the state of $252,496 for FY 08-09, $346,536 for FY 09-10, and $356,932 for FY 10-11. It is anticipated that $328 ($164 SGF and $164 FED) will be expended in FY 08-09 for the state's administrative expense for promulgation of this proposed rule and the final rule.

II.ESTIMATED EFFECT ON REVENUE COLLECTIONS OF STATE OR LOCAL GOVERNMENTAL UNITS (Summary)

It is anticipated that the implementation of this proposed rule will increase federal revenue collections by approximately $636,325 for FY 08-09, $873,661 for FY 09-10, and $899,871 for FY 10-11. It is anticipated that $164 will be expended in FY 08-09 for the federal administrative expenses for promulgation of this proposed rule and the final rule.

III.ESTIMATED COSTS AND/OR ECONOMIC BENEFITS TO DIRECTLY AFFECTED PERSONS OR NONGOVERNMENTAL GROUPS (Summary)

This rule, which continues the provisions of the September 1, 2008, emergency rule, proposes to increase the reimbursement rate paid for certain services provided to infants and toddlers with disabilities in the EarlySteps Program. It is anticipated that implementation of this proposed rule will increase expenditures in the Medicaid Program by approximately $888,493 for FY 08-09, $1,220,197 for FY 09-10 and $1,256,803 for FY 10-11.

IV.ESTIMATED EFFECT ON COMPETITION AND EMPLOYMENT (Summary)

It is anticipated that the implementation of this rule will have no effect on competition and employment.

Jerry Phillips

Robert E. Hosse

Medicaid Director

Legislative Fiscal Officer

0810#105

Legislative Fiscal Office

NOTICE OF INTENT

Louisiana Register   Vol. 34, No. 10   October 20, 2008

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