increasing access to prenatal care services.
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.
FISCAL AND ECONOMIC IMPACT STATEMENT FOR ADMINISTRATIVE RULES
RULE TITLE: State Children's Health Insurance Program—Coverage of Prenatal Care Services
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 $3,437,575 for FY 08-09, $4,226,900 for FY 09-10 and $4,685,350 for FY 10-11. While there will be an increase in programmatic expenditures as a result of the implementation of SCHIP prenatal care services, it is anticipated that there will be a cost avoidance in expenditures for emergency medical services in the future. However, we are unable to determine the approximate amount of savings at this time. It is anticipated that $492 ($246 SGF and $246 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 $13,853,305 for FY 08-09, $17,035,171 for FY 09-10 and $18,882,808 for FY 10-11. It is anticipated that $246 will be expended in FY 08-09 for the federal share of the expense 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 August 20, 2008 emergency rule, proposes to implement a stand-alone State Children’s Health Insurance Program (SCHIP) to provide prenatal care services to low-income, non-citizen women (approximately 2,035 recipients). It is anticipated that implementation of this proposed rule will result in an increase to the Medicaid Program of approximately $17,290,388 for FY 08-09, $21,262,071 for FY 09-10 and $23,568,158 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.
Robert E. Hosse
Legislative Fiscal Office
NOTICE OF INTENT
Department of Health and Hospitals
Office of the Secretary
Bureau of Health Services Financing
Targeted Case Management Reimbursement Methodology (LAC 50:XV.10701-10703)
The Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing proposes to amend LAC 50:XV.10701 and adopts §10703 under the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This proposed Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:950 et seq.
The Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing repromulgated the rules governing optional targeted case management services under the Medicaid Program for inclusion in the Louisiana Administrative Code (Louisiana Register, Volume 30, Number 5). The department promulgated an Emergency Rule to amend the provisions of the May 20, 2004 Rule governing the reimbursement methodology for targeted case management services to require case management agencies to bill in 15 minute increments and to establish cost reporting requirements (Louisiana Register, Volume 34, Number 5).
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 amend the May 1, 2008 Emergency Rule to increase the reimbursement rate paid for targeted case management services provided to infants and toddlers (Louisiana Register, Volume 34, Number 9). This proposed Rule is being promulgated to continue the provisions of the September 1, 2008 Emergency Rule.
PUBLIC HEALTH—MEDICAL ASSISTANCE
Part XV. Services for Special Populations
Subpart 7. Targeted Case Management
A.Effective for dates of service on or after May 1, 2008, reimbursement for case management services shall be a prospective rate for each approved unit of service provided to the recipient.
1.One quarter hour (15 minutes) is the standard unit of service which covers both service provision and administrative costs.
2.All services must be prior authorized.
B. – C.…
D.Effective for dates of service on or after September 1, 2008, the reimbursement rate for targeted case management services rendered to infants and toddlers shall be increased by 25 percent of the rate in effect on August 31, 2008.
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 30:1040 (May 2004), amended LR 31:2032
Louisiana Register Vol. 34, No. 10 October 20, 2008