La. Admin. Code tit. 50 § II-10107

Current through Register Vol. 50, No. 11, November 20, 2024

Section II-10107 - Change in Ownership

A. Assignment of Agreement

1. As a temporary measure during a change of ownership, the Bureau of Health Services Financing-Health Standards Section shall automatically assign the provider agreement and certification to the new owner. The new owner shall comply with all participation prerequisites simultaneously with the ownership transfer. Failure to promptly comply with these prerequisites may result in the interruption in vendor payment. The new owner shall be required to complete a new provider enrollment application.

2. Such an assignment is subject to all applicable statutes, regulations, terms, and conditions under which it was originally issued including, but not limited to, the following:

a. any existing corrective action plan;

b. any expiration date;

c. compliance with applicable health and safety standards;

d. compliance with the ownership and financial interest disclosure requirements;

e. compliance with civil rights requirements;

f. any facility need review rules that are applicable;

g. compliance with any additional requirements imposed by the Bureau of Health Services Financing, Health Services Section.

B. Continued Participation. For a facility to remain eligible for continued participation after a change of ownership, the facility shall meet all the following criteria:

1. state licensing requirements;

2. all Medicaid certification requirements;

3. Medicaid provider enrollment requirements including completion of a signed contract with DHH; and

4. compliance with title VI of the Civil Rights Act.

C. Ten Percent Withholding - Release of Payments

1. When a change of ownership occurs, a minimum of ten percent of the final vendor payment to the old legal entity is withheld pending the fulfillment of the following requirements:

a. Completion of a limited scope audit of the residents' funds account and the disposition requirements for nurse aide training funds with findings and any recommendations of a qualified accountant of the old legal entity's choice submitted to the BHSF Institutional Reimbursement Section. Old legal entities have 60 days to submit the audit findings to the Bureau of Health Services Financing Institutional Reimbursement Section once the section notifies the old owner that a limited scope audit is required. Failure of the old legal entity to comply is considered a class E violation and will result in fines as outlined in the Subchapter L entitled Sanctions.

b. The facility's compliance with the recommendations of the limited scope audit and the disposition requirements for nurse aide training funds with the following two exceptions.

i. If the new legal entity disputes the findings of the limited scope audit, said entity may engage an independent auditor and submit any findings and recommendations to the BHSF Institutional Reimbursement Section for review. In such instances, the independent auditor must certify his independence and submit a written opinion to the Bureau of Health Services Financing Institutional Reimbursement Section.

ii. New owners may provide the Bureau of Health Services Financing- Health Standards Section with a notarized document attesting that they shall be responsible for completion of and compliance with the limited scope audit and the disposition requirements for nurse aide training funds. New owners have 60 days to submit the audit findings to Bureau of Health Services Financing Institutional Reimbursement Section once the section notifies the new owner that a limited scope audit is required.

NOTE: Failure of the new owner to comply is considered a class E violation and will result in fines as outlined in the Subchapter L entitled Sanctions.

c. Submittal of an acceptable cost report by the old legal entity to Bureau of Health Services Financing Program Operations Section covering the period to the date of ownership change.

2. Once these requirements are met, the portion of the payment withheld shall be released by the Bureau of Health Services Financing Program Operations Section.

Note: If a SN-ID or SN-TDC changes ownership, the ten percent will not be released until the above requirements are met and after cost settlement.

D. Notification to Fiscal Intermediary. Upon notification of the ownership transfer and the new owner's licensure, the Bureau of Health Services Financing- Health Standards Section Provider Enrollment Unit shall notify the fiscal intermediary regarding the effective dates of payment and to whom payment is to be made.

La. Admin. Code tit. 50, § II-10107

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 22:34 (January 1996).

AUTHORITY NOTE: Promulgated in accordance with R.S. 46:153.