La. Admin. Code tit. 50 § V-5109

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

Section V-5109 - Children's Specialty Hospitals

A. In order to receive Medicaid reimbursement for outpatient services as a children's specialty hospital, the acute care hospital must meet the following criteria:

1. be recognized by Medicare as a prospective payment system (PPS) exempt children's specialty hospital;

2. does not qualify for Medicare disproportionate share hospital payments; and

3. has a Medicaid inpatient days utilization rate greater than the mean plus two standard deviations of the Medicaid utilization rates for all hospitals in the state receiving Medicaid payments.

La. Admin. Code tit. 50, § V-5109

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 39:327 (February 2013).

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