· Web viewCONTENTS September 2014 I. EXECUTIVE ORDERS BJ 14-10 Offender Labor 1645 BJ 14-11 In...

CONTENTSSeptember 2014

I.

EXECUTIVE ORDERS

BJ 14-10Offender Labor1645

BJ 14-11

In Memoriam1645

II.

POLICY AND PROCEDURE MEMORANDA

Governor

Division of Administration, Office of Contractual Review(PPM 50(Attorney Case Handling

Guidelines and Billing Procedures (LAC 4:V.Chapter 47)1646

III.

EMERGENCY RULES

Health and Hospitals

Bureau of Health Services Financing(Applied Behavioral Analysis-Based Therapy Services

(LAC 50:XV.Chapters 1-7)1648

Disproportionate Share Hospital Payments(Louisiana Low-Income Academic Hospitals

(LAC 50:V.Chapter 31)1650

Early and Periodic Screening, Diagnosis and Treatment(Personal Care Services

Removal of Parental Availability (LAC 50:XV.7305)1652

Family Planning Services (LAC 50:XV.Chapters 251-255)1652

Home Health Program(Rehabilitation Services(Reimbursement Rate Increase (LAC 50:XIII.Chapter 9)1653

Inpatient Hospital Services(Public-Private Partnerships(South Louisiana Area (LAC 50:V.1703)1654

Intermediate Care Facilities for Persons with Intellectual Disabilities(Public Facilities

Reimbursement Rate Increase (LAC 50:VII.32969)1655

Medicaid Eligibility(Provisional Medicaid Program (LAC 50:III.2305)1656

Medical Transportation Program(Emergency Aircraft Transportation

Rotor Winged Ambulance Services Rate Increase (LAC 50:XXVII.353)1657

Outpatient Hospital Services(Public-Private Partnerships(South Louisiana Area (LAC 50:V.6703)1658

Outpatient Hospital Services(Removal of Emergency Room Visit Limits (LAC 50.V.5117)1659

Professional Services Program(Immunizations(Reimbursement Methodology

(LAC 50:IX.8305 and 8505)1659

Professional Services Program(Physicians Services(Reimbursement Methodology (LAC 50:IX.15113)1661

Rehabilitation Clinics(Physical and Occupational Therapies(Reimbursement Rate Increase

(LAC 50:XI.301 and 303)1662

School Based Health Centers(Rehabilitation Services(Reimbursement Rate Increase

(LAC 50:XV.9141)1663

Therapeutic Group Homes (LAC 50:XXXIII.12101 and 12501)1663

Office for Citizens with Developmental Disabilities(Developmental Disabilities Services System

(LAC 48:IX.324)1664

Office of Behavioral Health(Therapeutic Group Homes (LAC 50:XXXIII.12101 and 12501)1663

Public Safety and Corrections

Office of Motor Vehicles(Driving Schools(Class D and E Licenses (LAC 55:III.Chapter 1)1666

Driving Schools(Surety Bonds (LAC 55:III.146 and 147)1669

Revenue

Office of the Secretary(Louisiana Tax Delinquency Amnesty Act of 2014 (LAC 61:I.4915)1670

Wildlife and Fisheries

Wildlife and Fisheries Commission(Greater Amberjack Commercial Season Closure1671

Recreational and Commercial Fisheries Reopenings1671

This public document was published at a total cost of $1,875. Two hundred fifty copies of this public document were published in this monthly printing at a cost of $1,875. The total cost of all printings of this document including reprints is $1,875. This document was published by Moran Printing, Inc. 5425 Florida Boulevard, Baton Rouge, LA 70806, as a service to the state agencies in keeping them cognizant of the new rules and regulations under the authority of R.S. 49:950-971 and R.S. 49:981-999. This material was printed in accordance with standards for printing bystate agencies established pursuant to R.S. 43:31. Printing of this material was purchased in accordance with the provisions of Title 43 of theLouisiana Revised Statutes.

The Office of the State Register provides auxiliary aids for the Louisiana Register for visually impaired individuals. By appointment, oral presentation of the Louisiana Register is available at the Office of the State Register, or an audiocassette tape of requested sections of the Louisiana Register can be provided for the cost incurred by the Office of the State Register in producing such a tape. For more information contact the Office of the State Register.

IV.

RULES

Children and Family Services

Division of Programs, Licensing Section(Licensing Class A and B Regulations for Child Care Centers

(LAC 67:III.Chapter 73)1674

Economic Stability Section(Family Independence Temporary Assistance Program (FITAP) and

Strategies to Empower People (STEP) Program (LAC 67:III.1213, 1229 and Chapter 57)1675

Civil Service

Board of Ethics(Food and Drink Limit (LAC 52:I.1703)1678

Culture, Recreation, and Tourism

Office of Cultural Development, Division of Historic Preservation(Application Fees for the

State Commercial Tax Credit Program (LAC 25:I.Chapter 13)1679

Education

Board of Elementary and Secondary Education(Bulletin 741(Louisiana Handbook for School Administrators

(LAC 28:CXV.2318)1679

Bulletin 746Louisiana Standards for State Certification of School Personnel (LAC 28:CXXXI.243)1680

Nonpublic Bulletin 741(Louisiana Handbook for Nonpublic School Administrators

(LAC 28:LXXIX.2102, 2109, and Chapter 23)1682

Board of Regents, Proprietary School Section(Minimum Cancellation and Refund Policy;

School Catalog; Forms (LAC 28:III.901 and 2301)1687

Environmental Quality

Office of the Secretary, Legal Division(Ambient Air Quality (LAC 33:III.711 and 918) (AQ344ft)1689

Conrad Industries Delisting (LAC 33:V.4999)(HW115)1691

Incorporation by Reference(LPDES Program (LAC 33:IX.4901 and 4903)(WQ089ft)1692

Governor

Board of Architectural Examiners(Reinstatement (LAC 46:I.1315)1693

Board of Examiners of Interior Designers(Use of Term (LAC46:XLIII.1001)1694

Board of Pardons, Committee on Parole(Meetings and Hearings of the Committee and Violations of Parole

(LAC 22:XI.513, 1113, and 1115)1695


Board of Dentistry(Oral Administration of Versed (LAC 46:XXXIII.1508)1696

Board of Nursing(Fees for Registration and Licensure (LAC 46:XLVII.3341)1696

Bureau of Health Services Financing(Behavioral Health Services(Physician Reimbursement Methodology

(LAC 50:XXXIII.1701)1697

Inpatient Hospital Services(Major Teaching Hospitals(Qualifying Criteria (LAC 50:V.Chapter 13)1697

Outpatient Hospital Services(Non-Rural, Non-State Public Hospitals(Supplemental Payments

(LAC 50:V.5315, 5515, 5717, 5915 and 6117)1699

Targeted Case Management(HIV Coverage Termination (LAC 50:XV.10505, 10701 and Chapter 119)1700

Targeted Case Management(Nurse Family Partnership(Program Termination

(LAC 50:XV.10505, 10701 and Chapter 111)1701

Office of Behavioral Health(Behavioral Health Services(Physician Reimbursement Methodology

(LAC 50:XXXIII.1701)1697

Insurance

Office of the Commissioner(Rule Number 8(Annuity Mortality Table for Use in Determining Reserve

Liabilities for Annuities (LAC 37:XI.Chapter 21)1702

V.NOTICE OF INTENT

Economic Development

Office of Business Development, Office of Entertainment Industry Development(Entertainment Industry

Tax Credit Programs(Motion Picture Investor Tax Credit Program (LAC 61:I.Chapter 16)1707

Office of the Secretary(Ports of Louisiana Tax Credits: Import-Export Tax Credit Program

(LAC 13:I.Chapter 39)1714

Education

Board of Elementary and Secondary Education(Bulletin 111(The Louisiana School, District, and State

Accountability System (LAC 28:LXXXIII.301, 515, 519, 703, 705, 707, 3901, 3903, 3905, and 4310)1717

Bulletin 118(Statewide Assessment Standards and Practices (LAC 28: CXI.107, 303, 305, 309, 312,

313, 316, 319, 701, 1301, 1803, 2000, 2001, 2003, 2011, 2012, 2013, 2014, 2015, 2016, 2035, 2037,

2039, 2501, 2901, 3303, and 3501)1721

Bulletin 119(Louisiana School Transportation Specifications and Procedures

(LAC 28:CXIII.301, 303, 2303, and Chapter 25)1728

Bulletin 126(Charter Schools (LAC 28:CXXXIX.309)1730

Bulletin 132(Louisiana Course Choice Program (LAC 28:CLI.103, 301, 303, 501, 503, 505, 507,

701, 1101, and 1301)1732

Bulletin 133(Scholarship Programs (LAC 28:CLIII.101, 301, 501, and 1101)1735

Bulletin 741(Louisiana Handbook for School Administrators(Career Diploma and Promotion

of Students with Exceptionalities (LAC 28: CXV.901, 2319, and 2397)1737

Bulletin 741(Louisiana Handbook for School Administrators(Curriculum and Instruction

(LAC 28:CXV.Chapter 23)1741

Bulletin 741(Louisiana Handbook for School Administrators(Dating Violence and Student

Code of Conduct (LAC 28:CXV.1129 and 1302)1746

Bulletin 741(Louisiana Handbook for School Administrators(High Schools (LAC 28:CXV.2317)1748

Bulletin 741(Louisiana Handbook for School Administrators(Instruction in Cardiopulmonary

Resuscitation and Automated External Defibrillators (LAC 28:CXV.337, 2305, and 2347)1749

Bulletin 1530(Louisiana's IEP Handbook for Students with Exceptionalities (LAC 28:XCVII.Chapter 4)1751

Bulletin 1566(Pupil Progression Policies and Procedures (LAC 28:XXXIX.503, 703, and 705)1753

Bulletin 1706(Regulations for Implementation of the Children with Exceptionalities Act

(LAC 28:XLIII.133)1755

Nonpublic Bulletin 741(Louisiana Handbook for Nonpublic School Administrators

(LAC 28:LXXIX.2109 and Chapter 23)1757

Student Financial Assistance Commission, Office of Student Financial Assistance

Scholarship/Grant Programs(TOPS Tech Early Start Award (LAC 28:IV.1001, 1003, 1005, 1007,

1009, 1011, 1013, 1015, 1017, and 1901)1762


Office of the Secretary, Legal Division(Incorporation by Reference(Existing Sewage Sludge

Incineration Units (LAC 33:III.3003)(AQ350ft)1765

Minor Source Permit Requirements (LAC 33:III.503 and 519)(AQ266)1766

Governor

Auctioneers Licensing Board(License(Apprentice Auctioneer (LAC 46:III.Chapter 11)1768

Board of Examiners of Interior Designers(Examination and Registration (LAC 46:XLIII.Chapter 9)1769

Board of Home Inspectors(Home Inspectors (LAC 46:XL.Chapter 1-7)1772

Division of Administration, Office of State Purchasing(Procurement (LAC 34:V.103, 106, 121, 134,

145-149, 187-201, 901, and 3103)1778

Division of Administration, Office of State Uniform Payroll(Charitable Organization Requirements and

Responsibilities (LAC 4:III.1111)1781

Licensing Board for Contractors(Contractors (LAC 46:XXIX.Chapters 1-15)1782


Board of Pharmacy(Pharmacy Compounding (LAC 46:LIII.Chapter 25)1785

Special Event Pharmacy Permit (LAC 46:LIII.Chapter 24)1788

Bureau of Health Services Financing(Adult Day Health Care(Standards for Payment

(LAC 50:II.Chapter 109)1791

Home and Community-Based Services Waivers(Supports Waiver

(LAC 50:XXI.5301, 5501, 5503, and Chapters 57-61)1793

Intermediate Care Facilities for Persons with Developmental Disabilities(Public Facilities

Reimbursement Methodology (LAC 50:VII.32969)1800

Prohibition of Provider Steering of Medicaid Recipients (LAC 50:I.Chapter 13)1801

Office for Citizens with Developmental Disabilities(Home and Community-Based Services Waivers

Supports Waiver (LAC 50:XXI.5301, 5501, 5503, and Chapters 57-61)1793

Office of Aging and Adult Services(Adult Day Health Care(Standards for Payment

(LAC 50:II.Chapter 109)1791

Office of Public Health(Reclassification of Failure to Obtain a Food Safety Certification as a

Class A Violation (LAC 51:I.113)1803

Registration of Foods, Drugs, Cosmetics, and Prophylactic Devices (LAC 51:VI.101 and 105)1805

Insurance

Office of the Commissioner(Approved Assurance Organizations (LAC 37:XIII.Chapter 145)1807

Natural Resources

Office of Coastal Management(Coastal Mitigation (LAC 43:I.724)1811

Coastal Use Permits (LAC 43:I.723)1813

Office of Conservation(E and P Waste for Hydraulic Fracture Stimulation(Statewide Order No. 29-B

(LAC 43:XIX.311 and 313)1814

Public Safety and Corrections

Corrections Services(Ameliorative Penalty Consideration (LAC 22:I.321)1815

Offender Incentive Pay and Other Wage Compensation (LAC 22:I.331)1817

Office of Motor Vehicles(Dealer, Educator, and Retired Law Officer Plates (LAC 55:III.Chapter 3)1820

Driving Schools(Class D and E Licenses (LAC 55:III.Chapter 1)1821

Driving Schools(Surety Bonds (LAC 55:III.146 and 147)1823

Electronic Reporting of Interlock Installation (LAC 55:III.Chapter 4)1824

Removal of License Plate when Owner/Operator is Suspended (LAC 55:III.329)1827

Title Transactions (LAC 55:III.395 and 397)1829

Office of State Police(Explosives(Inventory Reporting and Recordkeeping

(LAC 33:V.10107 and LAC 55:I.1505)1831

Uniform Construction Code Council(Uniform Construction Code (LAC 55:VI.301 and 901)1832

Revenue

Policy Services Division(Income and Franchise Tax (LAC 61:I.4907)1835

Income Tax Credits for Solar Energy Systems (LAC 61:I.1907)1837


Wildlife and Fisheries Commission(Possession of Potentially Dangerous Wild Quadrupeds,

Big Exotic Cats, and Non-Human Primates (LAC 76:V.115)1841

Removal of Abandoned Crab Traps (LAC 76:VII.367)1843

Workforce Commission

Office of Workers' Compensation(Appeals of the Decision of the Medical Director and

Preliminary Determinations of the Average Weekly Wage (LAC 40:I.5507)1844

VI.

POTPOURRI


Office of the Secretary, Legal Division(2012 Fine Particulate Matter 2.5 (PM2.5) National Ambient Air

Quality Standards (NAAQS) State Implementation Plan (SIP) Revisions1847


Board of Pharmacy(Substantive Change Hearing(Pharmacy Records

(LAC 46:LIII.Chapters 11, 12, and 15)1847

Emergency Response Network(Public Hearing(Substantive Changes to Proposed Rule; Requirements

for Louisiana Stroke Center Recognition; and Requirements for Louisiana STEMI Receiving Referral

Centers (LAC 48:I.Chapters 187 and 189)1848

Natural Resources

Office of Conservation, Environmental Division(Nelson Energy, Inc.(Hearing Notice1849

Office of the Secretary, Fishermens Gear Compensation Fund(Underwater Obstruction

Latitude/Longitude Coordinates1849


Wildlife and Fisheries Commission(Public Hearing(Louisiana Fisheries Forward Program

(LAC 76:VII.347)1849

VII.INDEX

1850

Executive Orders

EXECUTIVE ORDER BJ 14-10

Offender Labor

WHEREAS,during the 1988 Regular Session of the Louisiana Legislature, Act No. 933 was enacted relative to correctional facilities offender labor;

WHEREAS,as amended, Act No. 933, among other things, authorizes the governor to use offender labor in certain projects or maintenance or repair work; and

WHEREAS,the Act further provides that the governor, upon determining that it is appropriate and in furtherance of the rehabilitation and training of offenders, may, by executive order, authorize the use of offenders of a penal or correctional facility owned by the State of Louisiana for necessary labor in connection with a particular project.

NOW, THEREFORE I, BOBBY JINDAL, Governor of the State of Louisiana, by virtue of the authority vested by the Constitution and laws of the State of Louisiana, do hereby order and direct as follows:

SECTION 1:In furtherance of goals of the State of Louisiana of supporting positive offender welfare, rehabilitating offenders, reducing recidivism, and reintegrating offenders into society, offender labor is hereby authorized for the renovations of Building 10 at the Department of Corrections Headquarters complex, Baton Rouge, Louisiana, to be utilized for administrative offices.

SECTION 2:This Order is effective upon signature and shall continue in effect until amended, modified, terminated, or rescinded by the governor, or terminated by operation of law.

IN WITNESS WHEREOF, I have set my hand officially and caused to be affixed the Great Seal of Louisiana, at the Capitol, in the city of Baton Rouge, on this 11th day of August, 2014.

Bobby Jindal

Governor

ATTEST BY

THE GOVERNOR

Tom Schedler

Secretary of State

1409#110

EXECUTIVE ORDER BJ 14-11

In Memoriam

WHEREAS,every year, on September 11th, the people of Louisiana recognize and honor all those who lost their lives on September 11, 2001, as well as the heroic men and women who sacrificed their lives through civilian and military service in connection with related ongoing overseas combat operations;

WHEREAS,since September 11, 2001, the people of Louisiana have lost many brave men and women in these combat operations and more are currently risking their lives daily in defense of our freedom;

WHEREAS,September 11, 2014, marks the thirteen year anniversary of the tragic events that occurred on September 11, 2001, and provides a special opportunity for remembering their patriotic commitment to the democratic principles of freedom and equality;

WHEREAS,these service members represent all branches of the armed forces, the Marines, Army, Air Force, Navy, Coast Guard, National Guard and Reserves;

WHEREAS,these courageous and ambitious Louisianians loved their country and the military and devoted their lives to serving their state and country;

WHEREAS,all tragically lost their lives giving their last full measure of devotion in defense of our beloved country and the freedoms that we as Americans hold dear;

WHEREAS,the memory of these dedicated men and women will live on in the hearts of their family, friends, and fellow service members forever.

NOW THEREFORE, I, BOBBY JINDAL, Governor of the State of Louisiana, by virtue of the authority vested by the Constitution and the laws of the State of Louisiana, do hereby order and direct as follows:

SECTION 1:As an expression of respect for Louisianas fallen civilian and service members who lost their lives on September 11, 2001, and the days since to defend this country, as well as those who continue to proudly serve, the flags of the United States and the State of Louisiana shall be flown at half staff over the State Capitol and all public buildings and institutions of the State of Louisiana from sunrise September 11, 2014, until sunset September 11, 2014.

SECTION 2:This Order is effective upon signature and shall remain in effect until amended, modified, terminated or rescinded.

IN WITNESS WHEREOF, I have set my hand officially and caused to be affixed the Great Seal of Louisiana, at the Capitol, in the city of Baton Rouge, on this 10th day of September, 2014.

Bobby Jindal

Governor

ATTEST BY

THE GOVERNOR

Tom Schedler

Secretary of State

1409#111

Policy and Procedure Memoranda

POLICY AND PROCEDURE MEMORANDA

Office of the Governor

Division of Administration Office of Contractual Review

PPM 50(Attorney Case Handling Guidelines and Billing Procedures (LAC 4:V.Chapter 47)

Title 4

ADMINISTRATION

Part V. Policy and Procedure Memoranda

Chapter 47.Attorney Case Handling Guidelines and Billing Procedures(PPM Number 50

4701.Goal

A.For executive branch agencies that hire attorneys under professional services contracts controlled by Chapter 16 of Title 39 of the Louisiana Revised Statutes (controlled by Chapter 17 of Title 39 commencing January 1, 2015), the Commissioner of Administration and the Division of Administration (DOA) expects to work with those agencies to hire and to retain attorneys in an efficient and cost conscious manner consistent with ethical obligations. Nothing contained herein is intended to restrict an agency or its contract counsels exercise of professional judgment in rendering legal services. Contract counsel bears ultimate responsibility for all work performed pursuant to the contract and/or billed to the file.

AUTHORITY NOTE:Promulgated in accordance with R.S. 49:258 and R.S. 39:1490(A); Act 864 of 2014 Regular Legislative Session.

HISTORICAL NOTE:Promulgated by the Office of the Governor, Division of Administration, LR 40:1646 (September 2014).

4702.Authorization and Legal Basis

In accordance with R.S. 39:1490(A) which authorizes the Office of Contractual Review (Office of State Procurement commencing January 1, 2015) to consider and decide all matters of policy relative to professional, personal, consulting and social services, and which mandates the periodic audit and review, implementation of rules and regulations, and policy determinations regarding professional, personal, consulting and social services contracts, notice is hereby given as to the establishment and implementation of Policy and Procedure Memorandum No. 50(Attorney Case Handling Guidelines and Billing Procedures.

AUTHORITY NOTE:Promulgated in accordance with R.S. 39:1490(A); Act 864 of 2014 Regular Legislative Session.


4703.Policy

A.To control costs, to increase efficiencies and to insure quality and standard billing practices, in addition to all legal requirements, any agency that contracts for attorney services under Title 39 of the Louisiana Revised Statutes, shall, by January 1, 2015, institute case handling guidelines and billing procedures to be incorporated by reference into all professional contracts for attorney services entered into.

B.Effective September 20, 2014, all professional contracts entered into for attorney services under Title 39 of the Louisiana Revised Statutes after September 20, 2014, and all case handling guidelines and billing procedures in existence or which shall be thereafter instituted, shall include the following minimum requirements which may be referred to by reference by citing PPM 50.

1.Attachment to all Attorney Contracts. These case handling guidelines and billing procedures supplement, but do not replace, an agencys existing attorney case handing and billing procedures, and shall not supersede any rules or regulations in effect for legal contracts. To the extent that these requirements are more stringent than an agencys existing requirements, they shall supersede those requirements.

2.Attorney Rates. Unless justification is provided and approval is received, all attorney billing rates shall conform to the standard rates set by the Attorney General.

3.Billing Management. Each contracting agency shall designate in writing the employee authorized to approve work and travel performed pursuant to the contract, and who is responsible for ensuring that attorney case handling guidelines and billing procedures are followed.

4.Budgeting. Within 60 days of entering into a contract for attorney services, the contracting attorney shall prepare a legal budget after assessing the underlying case. If it is anticipated that the budget will exceed the maximum value of the contract, then the agency shall immediately take the necessary steps to increase the contracts maximum value. An agency shall prepare a report when 80% of the established budget has been expended which shall project the final cost of the attorney services expected to be provided under the contract.

5.Clerical Work. Clerical work, including work performed by law clerks, paralegals and secretaries shall not be billed unless written justification is submitted and approved.

6.Depositions/Inspections/Hearings on Motions. Unless approved in advance by the contracting agency, only one attorney shall attend and bill for depositions, inspections and hearings on motions.

7.Documentation of Reimbursed Expenses. The contracting attorney must retain and provide all receipts and other documentation of expenses where reimbursement has been preapproved. Advanced court costs by state agencies is not required under the law in most situations. Payment of advanced court costs will not be reimbursed until a lawsuit is completed unless preapproval for the payment of same is obtained.

8.Dual or Overlapping Billing. Billing for work for other clients or for unrelated State matters simultaneously while performing work under the billed contract shall be prohibited. Billing by two approved attorneys simultaneously should be avoided unless or approved by the agency in advance.

9.Duplication of Work. Duplication or repetition of effort among attorneys shall be avoided.

10.Maximum Amount. All contracts for attorney services entered into shall provide for a maximum value which shall not be exceeded through addendum, amendment, or renewal without the contractor and the agency documenting the justification in writing.

11.Minimum Billing Increments. All billing items shall be billed at increments of .10 (six minute increments). No block billing shall be accepted.

12.Non-Conforming Bills. Any bill which does not conform to these billing requirements shall not be paid until such time as it is determined that the non-conforming items have been corrected. Any payment dispute under a contract for attorney services shall be administratively determined pursuant to Chapter 16, Title 39 of the Louisiana Revised Statutes.

13.Office Overhead; Copying Phone Charges, etc. All office overhead, including costs for copying, facsimile, email, internet or phone charges shall not be billed unless an agency has agreed in advance under the terms and conditions of its contract approved by OCR to reimburse the actual cost of these items.

14.Record Retention. Daily time sheets maintained by attorney name, caption, and case number shall be utilized. Attorneys are required to maintain any and all bills and supporting documentation, including daily time sheets, for five years. Billing records are subject to audit by DOA, the Inspector General and the Legislative Auditor.

15.Reports. A contracting agency shall not pay for any time charged for preparation of reporting forms or status reports other than those specifically requested or specifically required under the terms and conditions of the contract. Any report that does not contain significant new information or developments with a clear explanation of the impact on the case should not be requested or required by the contracting agency. Automatic periodic reporting in increments of less than three months should be avoided.

16.Research. Legal research per contract shall not exceed five hours without additional approval by the using agency.

17.Routine Matters. Routine scheduling, mail handling, new file set up, calendar maintenance, transcribing, copying, faxing, data entry enclosure letters, simple letters to clerks of court, and other similar routine matters are non-billable.

18.Staffing. Only those attorneys who are directly contracted, and approved staff, may work under the contract. Any staffing changes must be discussed and approved prior to engaging in billable work.

19.Task and Item Billing. Specific task and item billing must occur under every contract for attorney services, even where an attorney is retained by an agency to provide general legal services and advice. Billing for attorney services shall occur, at a minimum, monthly. All billing statements shall reference the contract number under which it is being submitted.

20.Term of Contract. No contract for attorney services shall be longer than three years. Prior to such a contract entering into the third year of its term, however, the attorney and the contracting agency shall provide written justification to continue the contract into the third year. Failure to provide written justification to extend a contract may result in cancellation of the contract.

21.Travel. Travel time shall be preapproved and shall be billed at one-half the agreed upon attorney pay rate. Travel time for a specific task shall not be approved to exceed eight hours per day without written justification. All related travel expenses shall also be preapproved and will be reimbursed in accordance with PPM 49(Louisiana State Travel Rules and Regulations.

22.Trial Preparation and Attendance. Trial preparation and attendance shall be billed only at the regular rate established in the contract. Tasks associated with trial preparation should occur once and only within a reasonable timeframe prior to trial. Unless approved in advance, only one attorney shall bill for trial preparation and for attending trial.

AUTHORITY NOTE:Promulgated in accordance with R.S. 39:1490(A).


4705.Effective Date

A.This policy shall apply to all new contracts by reference entered into on or after September 20, 2014, and shall remain in existence after January 1, 2015, when the Office of Contractual review is merged into the Office of State Procurement.

AUTHORITY NOTE:Promulgated in accordance with R.S. 39:1490(A) and Act 864 of 2014 Regular Legislative Session.


4707.Notice to Agencies Regarding Electronic Billing Platforms

A.The DOA is currently conducting a pilot program regarding a web-based electronic billing platform for the submission and review of attorney bills by executive branch agencies. Until the pilot program is concluded, no executive branch agency at the department level shall pursue or issue a contract for a new electronic billing platform for attorney services, and shall not extend any existing contract for such a platform, without the approval of the Office of Contractual Review and the Office of State Purchasing.

AUTHORITY NOTE:Promulgated in accordance with R.S. 39:1561(B) and R.S. 39:1490(A).


Pamela Bartfay Rice

Director

Office of Contractual Review

1409#112

Emergency Rules

DECLARATION OF EMERGENCY

Department of Health and Hospitals

Bureau of Health Services Financing

Applied Behavioral Analysis-Based Therapy Services(LAC 50:XV.Chapters 1-7)

The Department of Health and Hospitals, Bureau of Health Services Financing adopts LAC 50:XV.Chapters 1-7 in the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This Emergency Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:953(B)(1) et seq., and shall be in effect for the maximum period allowed under the Act or until adoption of the final Rule, whichever occurs first.

The Department of Health and Hospitals, Bureau of Health Services Financing and the Office for Citizens with Developmental Disabilities promulgated an Emergency Rule which amended the provisions of the Childrens Choice Waiver in order to provide for the allocation of waiver opportunities to Medicaid-eligible children identified in the Melanie Chisholm, et al vs. Kathy Kliebert class action litigation (hereafter referred to as Chisholm class members) who have a diagnosis of pervasive developmental disorder or autism spectrum disorder, and are in need of applied behavioral analysis-based (ABA) therapy services. (Louisiana Register, Volume 39, Number 10). This action was taken as a temporary measure to ensure Chisholm class members would have access to ABA therapy services as soon as possible.

To ensure continued, long-lasting access to ABA-based therapy services for Chisholm class members and other children under the age of 21, the department promulgated an Emergency Rule which adopted provisions to establish coverage and reimbursement for ABA-based therapy services under the Medicaid State Plan (Louisiana Register, Volume 40, Number 2). This Emergency Rule is being promulgated to continue the provisions of the February 1, 2014 Emergency Rule.

This action is being taken to avoid imminent peril to the public health and welfare of children who are in immediate need of ABA-based therapy services, and to comply with the judges order that these services be provided to Chisholm class members.

Effective October 1, 2014, the Department of Health and Hospitals, Bureau of Health Services Financing adopts provisions to establish coverage and reimbursement for applied behavioral analysis-based therapy services under the Medicaid State Plan.

Title 50

PUBLIC HEALTH(MEDICAL ASSISTANCE

Part XV. Services for Special Populations

Subpart 1. Applied Behavioral Analysis-Based Therapy Services

Chapter 1.General Provisions

101.Program Description and Purpose

A.Applied behavioral analysis-based (ABA) therapy is the design, implementation, and evaluation of environmental modification using behavioral stimuli and consequences to produce socially significant improvement in human behavior, including the direct observation, measurement, and functional analysis of the relations between environment and behavior. ABA-based therapies teach skills through the use of behavioral observation and reinforcement or prompting to teach each step of targeted behavior. ABA-based therapies are based on reliable evidence and are not experimental.

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, Bureau of Health Services Financing, LR 40:

103.Recipient Criteria

A.In order to qualify for ABA-based therapy services, a Medicaid recipient must meet the following criteria. The recipient must:

1.be from birth up to 21 years of age;

2.exhibit the presence of excesses and/or deficits of behaviors that significantly interfere with home or community activities (examples include, but are not limited to aggression, self-injury, elopement, etc.);

3.be medically stable and does not require 24-hour medical/nursing monitoring or procedures provided in a hospital or intermediate care facility for persons with intellectual disabilities (ICF/ID);

4.be diagnosed by a qualified health care professional with a condition for which ABA-based therapy services are recognized as therapeutically appropriate, including autism spectrum disorder;

5.have a comprehensive diagnostic evaluation by a qualified health care professional; and

6.have a prescription for ABA-based therapy services ordered by a qualified health care professional.

B.All of the criteria in 103.A must be met to receive services.



Chapter 3.Services

301.Covered Services and Limitations

A.Medicaid covered ABA-based therapy services must be:

1.medically necessary;

2.prior authorized by the Medicaid Program or its designee; and

3.delivered in accordance with the recipients treatment plan.

B.Services must be provided directly or billed by behavior analysts licensed by the Louisiana Behavior Analyst Board.

C.Medical necessity for ABA-based therapy services shall be determined according to the provisions of the Louisiana Administrative Code (LAC), Title 50, Part I, Chapter 11 (Louisiana Register, Volume 37, Number 1).

D.ABA-based therapy services may be prior authorized for a time period not to exceed 180 days. Services provided without prior authorization shall not be considered for reimbursement, except in the case of retroactive Medicaid eligibility.

E.Service Limitations

1.Services shall be based upon the individual needs of the child, and must give consideration to the childs age, school attendance requirements, and other daily activities as documented in the treatment plan.

2.Services must be delivered in a natural setting (e.g., home and community-based settings, including clinics).

3.Any services delivered by direct line staff must be under the supervision of a lead behavior therapist who is a Louisiana licensed behavior analyst.

F.Not Medically Necessary/Non-Covered Services. The following services do not meet medical necessity criteria, nor qualify as Medicaid covered ABA-based therapy services:

1.therapy services rendered when measureable functional improvement is not expected or progress has plateaued;

2.services that are primarily educational in nature;

3.services that are duplicative services under an individualized family service plan (IFSP) or an individualized educational program (IEP), as required under the federal Individuals with Disabilities Education Act (IDEA);

4.treatment whose purpose is vocationally- or recreationally-based;

5.custodial care;

a.for purposes of these provisions, custodial care:

i.shall be defined as care that is provided primarily to assist in the activities of daily living (ADLs), such as bathing, dressing, eating, and maintaining personal hygiene and safety;

ii.is provided primarily for maintaining the recipients or anyone elses safety; and

iii.could be provided by persons without professional skills or training; and

6.services, supplies, or procedures performed in a non-conventional setting including, but not limited:

a.resorts;

b.spas;

c.therapeutic programs; and

d.camps.



303.Treatment Plan

A.ABA-based therapy services shall be rendered in accordance with the individuals treatment plan. The treatment plan shall:

1.be person-centered and based upon individualized goals;

2.be developed by a licensed behavior analyst;

3.delineate both the frequency of baseline behaviors and the treatment development plan to address the behaviors;

4.identify long, intermediate, and short-term goals and objectives that are behaviorally defined;

5.identify the criteria that will be used to measure achievement of behavior objectives;

6.clearly identify the schedule of services planned and the individual providers responsible for delivering the services;

7.include care coordination involving the parents or caregiver(s), school, state disability programs, and others as applicable;

8.include parent/caregiver training, support, and participation;

9.have objectives that are specific, measureable, based upon clinical observations, include outcome measurement assessment, and tailored to the individual; and

10.ensure that interventions are consistent with ABA techniques.



Chapter 5.Provider Participation

501.General Provisions

A.Licensed behavior analysts that render ABA-based therapy services shall meet the following provider qualifications:

1.be licensed by the Louisiana Behavior Analyst Board;

2.be covered by professional liability insurance to limits of $1,000,000 per occurrence, $1,000,000 aggregate;

3.have no sanctions or disciplinary actions on their Board Certified Behavior Analyst (BCBA) or Board Certified Behavior Analyst-Doctoral (BCBA-D) certification and/or state licensure;

4.not have Medicare/Medicaid sanctions, or be excluded from participation in federally funded programs (i.e., Office of Inspector Generals List of excluded individuals/entities (OIG-LEIE), system for award management (SAM) listing and state Medicaid sanctions listings); and

5.have a completed criminal background check to include federal criminal, state criminal, parish criminal and sex offender reports for the state and parish in which the behavior analyst is currently working and residing.

a.Criminal background checks must be performed at the time of hire and at least five years thereafter.

b.Background checks must be current, within a year prior to the initial Medicaid enrollment application. Background checks must be performed at least every five years thereafter.

B.Certified assistant behavior analyst that render ABA-based therapy services shall meet the following provider qualifications:

1.must be certified by the Louisiana Behavior Analyst Board;

2.must work under the supervision of a licensed behavior analyst;

a.the supervisory relationship must be documented in writing;

3.must have no sanctions or disciplinary actions, if state-certified or board-certified by the BACB;

4.may not have Medicare or Medicaid sanctions, or be excluded from participation in federally funded programs (i.e., Office of Inspector Generals list of excluded individuals/entities (OIG-LEIE), system for award management (SAM) listing and state Medicaid sanctions listings); and

5.have a completed criminal background check to include federal criminal, state criminal, parish criminal and sex offender reports for the state and parish in which the certified assistant behavior analyst is currently working and residing.

a.Evidence of this background check must be provided by the employer.

b.Criminal background checks must be performed at the time of hire and an update performed at least every five years thereafter.

C.Registered line technicians that render ABA-based therapy services shall meet the following provider qualifications:

1.must be registered by the Louisiana Behavior Analyst Board;

2.must work under the supervision of a licensed behavior analyst;

a.the supervisory relationship must be documented in writing;

3.may not have Medicaid or Medicare sanctions or be excluded from participation in federally funded programs (OIG-LEIE listing, SAM listing and state Medicaid sanctions listings); and

4.have a completed criminal background check to include federal criminal, state criminal, parish criminal and sex offender reports for the state and parish in which the certified assistant behavior analyst is currently working and residing.

a.Evidence of this background check must be provided by the employer.

b.Criminal background checks must be performed at the time of hire and an update performed at least every five years thereafter.



Chapter 7.Reimbursements


A.The Medicaid Program shall provide reimbursement for ABA-based therapy services to enrolled behavior analysts who are currently licensed and in good standing with the Louisiana Behavior Analyst Board.

B.Reimbursement for ABA services shall not be made to, or on behalf of services rendered by, a parent, a legal guardian or legally responsible person.



703.Reimbursement Methodology

A.Reimbursement for ABA-based therapy services shall be based upon a percentage of the commercial rates for ABA-based therapy services in the state of Louisiana. The rates are based upon 15 minute units of service, with the exception of mental health services plan which shall be reimbursed at an hourly fee rate.

B.Reimbursement shall only be made for services authorized by the Medicaid Program or its designee.



Interested persons may submit written comments to J. Ruth Kennedy, Bureau of Health Services Financing, P.O. Box 91030, Baton Rouge, LA 70821-9030 or by email to [email protected]. Ms. Kennedy is responsible for responding to inquiries regarding this Emergency Rule. A copy of this Emergency Rule is available for review by interested parties at parish Medicaid offices.

Kathy H. Kliebert

Secretary

1409#089




Disproportionate Share Hospital PaymentsLouisiana Low-Income Academic Hospitals(LAC 50:V.Chapter 31)

The Department of Health and Hospitals, Bureau of Health Services Financing adopts LAC 50:V.Chapter 31 in the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This Emergency Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:953(B)(1) et seq., and shall be in effect for the maximum period allowed under the Act or until adoption of the final Rule, whichever occurs first.

The Department of Health and Hospitals, Bureau of Health Services Financing promulgated Emergency Rules which amended the provisions governing disproportionate share hospital (DSH) payments to hospitals participating in public-private partnerships in the south and north Louisiana areas (Louisiana Register, Volume 39, Numbers 7 and 10). As a result of the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services disapproval of the corresponding State Plan Amendments, the department determined that it was necessary to repeal the provisions of the July 6, 2013 and October 1, 2013 Emergency Rules governing DSH payments to the hospitals participating in the south and north Louisiana area public-private partnerships.

The department promulgated an Emergency Rule which amended the provisions governing DSH payments in order to establish payments to Louisiana Low-Income Academic Hospitals (Louisiana Register, Volume 40, Number 6). The department now proposes to amend the provisions of the May 24, 2014 Emergency Rule to clarify the provisions governing the payment methodology to Louisiana Low-Income Academic Hospitals. This action is being taken to promote the health and welfare of Medicaid recipients by maintaining recipient access to much needed hospital services.

Effective September 20, 2014 the Department of Health and Hospitals, Bureau of Health Services Financing amends the provisions of the May 24, 2014 Emergency Rule governing DSH payments to Low-Income Academic Hospitals.

Title 50


Part V. Hospital Services

Subpart 3. Disproportionate Share Hospital Payments

Chapter 31.Louisiana Low-Income Academic Hospitals

3101.Qualifying Criteria

A.Hospitals Located Outside of the Lake Charles Metropolitan Statistical Area

1.Effective for dates of service on or after May 24, 2014, a hospital may qualify for this category by:

a.being a private acute care general hospital that is located outside of the Lake Charles metropolitan statistical area (MSA);

b.having uninsured patient utilization, as measured by allowable uninsured inpatient and outpatient charges, greater than 20 percent. Qualification shall be based on uninsured utilization data per the prior state fiscal year date of service time period; and

c.maintaining at least 15 unweighted intern and resident full-time equivalent positions, as reported on the Medicare Cost Report Worksheet E-4, line 6.

B.Hospitals Located In the Lake Charles Metropolitan Statistical Area

1.Effective for dates of service on or after May 24, 2014, a hospital may qualify for this category by:

a.being a private acute care general hospital that is located in the Lake Charles MSA;

b.having uninsured patient utilization, as measured by allowable uninsured inpatient and outpatient charges, greater than 10 percent. To determine qualification in state fiscal year 2014, the first six month dates of service time period (July 1, 2013 through December 31, 2013) shall be used. In subsequent state fiscal years, qualification shall be based on uninsured utilization data per the prior state fiscal year date of service time period; and

c.maintaining at least 20 unweighted intern and resident full-time equivalent positions, as reported on the Medicare Cost Report Worksheet E-4, line 6.



3103.Payment Methodology

A.Each qualifying hospital shall be paid DSH adjustment payments equal to 100 percent of allowable hospital specific uncompensated care costs subject to the Appropriations Act. DSH payments to qualifying hospitals shall not exceed the disproportionate share limits as defined in Section 1923(g)(1) (A) of the Social Security Act for the state fiscal year to which the payment is applicable.

B.Payment Calculation

1.For the initial years payment calculation, each qualifying hospital shall submit interim actual cost data calculated utilizing Medicaid allowable cost report principles, along with actual Medicaid and uninsured patient charge data. Annual Medicaid costs shortfalls and unreimbursed uninsured patient costs are determined based on review and analysis of these submissions.

2.For subsequent years payment calculations, the most recent Medicaid filed cost report along with actual Medicaid and uninsured patient charge data annualized from the most recent calendar year completed quarter is utilized to calculate hospital specific uncompensated care costs.

C.The department shall review cost data, charge data, lengths of stay and Medicaid claims data per the Medicaid Management and Information Systems (MMIS) for reasonableness before payments are made.

D.The first payment of each fiscal year will be made by October 15 and will be 80 percent of the annual calculated uncompensated care costs. The remainder of the payment will be made by June 30 of each year.

1.Reconciliation of these payments to actual hospital specific uncompensated care costs will be made when the cost report(s) covering the actual dates of service from the state fiscal year are filed and reviewed.

2.Additional payments or recoupments, as needed, shall be made after the finalization of the Centers for Medicare and Medicaid Services (CMS) mandated DSH audit for the state fiscal year.

E.No payment under this Section is dependent on any agreement or arrangement for providers or related entities to donate money or services to a governmental entity.



Implementation of the provisions of this Rule may 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 J. Ruth Kennedy, Bureau of Health Services Financing, P.O. Box 91030, Baton Rouge, LA 70821-9030 or by email to [email protected]. Ms. Kennedy is responsible for responding to all inquiries regarding this Emergency Rule. A copy of this Emergency Rule is available for review by interested parties at parish Medicaid offices.

Kathy H. Kliebert

Secretary

1409#081




Early and Periodic Screening, Diagnosis and TreatmentPersonal Care ServicesRemoval of Parental Availability(LAC 50:XV.7305)

The Department of Health and Hospitals, Bureau of Health Services Financing amends LAC 50:XV.7305 in the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This Emergency Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:953(B)(1) et seq., and shall be in effect for the maximum period allowed under the Act or until adoption of the final Rule, whichever occurs first.

The Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing amended the provisions governing personal care services covered in the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program in order to revise the reimbursement methodology to be consistent with current payment methodologies (Louisiana Register, Volume 36, Number 11).

The Department of Health and Hospitals, Bureau of Health Services Financing promulgated an Emergency Rule which amended the provisions governing EPSDT personal care services in order to revise the recipient qualifications to remove the criteria regarding parental/caregiver availability in the home (Louisiana Register, Volume 40, Number 6). The department has now determined that it is necessary to amend the provisions of the June 1, 2014 Emergency Rule in order to revise the formatting of these provisions. This will ensure that these provisions are appropriately incorporated into the Louisiana Administrative Code in a clear and concise manner. This action is being taken to promote the health and well-being of children by ensuring access to EPSDT personal care services.

Effective September 20, 2014, the Department of Health and Hospitals, Bureau of Health Services Financing amends the provisions of the June 1, 2014 Emergency Rule governing EPSDT personal care services.

Title 50



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

Chapter 73.Personal Care Services

7305.Recipient Qualifications

A. - A.3....

4.Early and Periodic Screening, Diagnosis, and Treatment personal care services must be prescribed by the recipients attending physician initially and every 180 days thereafter (or rolling six months), and when changes in the plan of care occur. The plan of care shall be acceptable for submission to BHSF only after the physician signs and dates the completed form. The physicians signature must be an original signature and not a rubber stamp.

5.Repealed.


HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 29:177 (February 2003), amended LR 30:253 (February 2004), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 40:

Interested persons may submit written comments to J. Ruth Kennedy, Bureau of Health Services Financing, P.O. Box 91030, Baton Rouge, LA 708219030 or by email to [email protected]. Ms. Kennedy is responsible for responding to inquiries regarding this Emergency Rule. A copy of this Emergency Rule is available for review by interested parties at parish Medicaid offices.

Kathy H. Kliebert

Secretary

1409#082




Family Planning Services (LAC 50:XV.Chapters 251-255)

The Department of Health and Hospitals, Bureau of Health Services Financing amends LAC 50:XV.Chapters 251-255 in the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This Emergency Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:953(B)(1) et seq., and shall be in effect for the maximum period allowed under the Act or until adoption of the final Rule, whichever occurs first.

The Department of Health and Hospitals, Bureau of Health Services Financing adopted provisions to establish a new optional eligibility group under the Medicaid State Plan to provide coverage for family planning services and supplies (Louisiana Register, Volume 40, Number 6). The department promulgated an Emergency Rule which amended the provisions governing family planning services to revise and clarify the provisions of the June 20, 2014 Rule (Louisiana Register, Volume 40, Number 6). The department has determined that it is now necessary to amend the provisions of the June 20, 2014 Emergency Rule in order to revise the formatting of these provisions in order to ensure that the provisions are appropriately incorporated into the Louisiana Administrative Code.

This action is being taken to avoid sanctions or federal penalties from the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) for noncompliance with federal requirements and to insure that the provisions of this rule are properly formatted in the Louisiana Administrative Code.

Effective September 20, 2014, the Department of Health and Hospitals, Bureau of Health Services Financing amends the provisions of the June 20, 2014 Emergency Rule governing family planning State Plan services.

Title 50



Subpart 17. Family Planning Services

Chapter 251.General Provisions

25101.Purpose

A.Effective July 1, 2014, the Medicaid Program shall provide coverage of family planning services and supplies under the Medicaid State Plan, to a new targeted group of individuals who are otherwise ineligible for Medicaid. This new optional coverage group may also include individuals receiving family planning services through the Section 1115 demonstration waiver, Take Charge Program, if it is determined that they meet the eligibility requirements for the State Plan family planning services.

B.The primary goals of family planning services are to:

1.increase access to services which will allow improved reproductive and physical health;

2.improved perinatal outcomes; and

3.reduce the number of unintended pregnancies.


HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 40:1097 (June 2014), amended LR 40:

Chapter 253.Eligibility Criteria

25301.Recipient Qualifications

A.Recipients who qualify for family planning services in the new categorically needy group include individuals of child bearing age who meet the following criteria:

1.women who are not pregnant and have income at or below 138 percent of the federal poverty level; and

2.men who have income at or below 138 percent of the federal poverty level.

3.Repealed.



Chapter 255.Services

25501.Covered Services

A.Medicaid covered family planning services include:

1.seven office visits per year for physical examinations or necessary re-visits as it relates to family planning or family planning-related services;

2.contraceptive counseling (including natural family planning), education, follow-ups and referrals;

3.laboratory examinations and tests for the purposes of family planning and management of sexual health;

4.pharmaceutical supplies and devices to prevent conception, including all methods of contraception approved by the Federal Food and Drug Administration; and

a. - c.Repealed.

5.male and female sterilization procedures and follow-up tests provided in accordance with 42 CFR 441, Subpart F.

B.Family planning-related services include the diagnosis and treatment of sexually transmitted diseases or infections, regardless of the purpose of the visit at which the disease or infection was discovered. Medicaid covered family planning-related services include:

1.diagnostic procedures, drugs and follow-up visits to treat a sexually transmitted disease, infection or disorder identified or diagnosed at a family planning visit (other than HIV/AIDS or hepatitis);

2.annual family planning visits for individuals, both males and females of child bearing age, which may include:

a.a comprehensive patient history;

b.physical, including breast exam;

c.laboratory tests; and

d.contraceptive counseling;

3.vaccine to prevent cervical cancer;

4.treatment of major complications from certain family planning procedures; and

5.transportation services.

C. - C.5.Repealed.




Kathy H. Kliebert

Secretary

1409#083




Home Health ProgramRehabilitation ServicesReimbursement Rate Increase(LAC 50:XIII.Chapter 9)

The Department of Health and Hospitals, Bureau of Health Services Financing repeals the provisions of the June 20, 1997, May 20, 2001, and the May 20, 2004 Rules governing rehabilitation services and adopts LAC 50:XIII.Chapter 9 in the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This Emergency Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:953(B)(1) et seq., and shall be in effect for the maximum period allowed under the Act or until adoption of the final Rule, whichever occurs first.

The Department of Health and Hospitals, Bureau of Health Services Financing provides Medicaid reimbursement for rehabilitation services covered in the Home Health Program. In compliance with a court order from the Melanie Chisholm, et al vs. Kathy Kliebert class action litigation, the Department of Health and Hospitals, Bureau of Health Services Financing promulgated an Emergency Rule which amended the provisions governing rehabilitation services covered under the Home Health Program in order to increase the reimbursement rates for physical and occupational therapy services for recipients under the age of 21, and to discontinue the automatic enhanced rate adjustment for these services (Louisiana Register, Volume 40, Number 2). This Emergency Rule also repealed the June 20, 1997, May 20, 2001, and the May 20, 2004 Rules governing rehabilitation services covered in the Home Health Program, and revised and repromulgated the provisions in a codified format for inclusion in the Louisiana Administrative Code. This Emergency Rule is being promulgated to continue the provisions of the February 13, 2014 Emergency Rule.

This action is being taken to promote the health and welfare of Medicaid recipients by ensuring continued access to therapy services in the Home Health Program.

Effective October 13, 2014, the department amends the provisions governing the Home Health Program in order to increase the reimbursement rates for physical and occupational therapy services provided to recipients under the age of 21, and to discontinue the automatic enhanced rate adjustment for these services.

Title 50


Part XIII. Home Health

Subpart 1. Home Health Services

Chapter 9.Rehabilitation Services


A. The Medicaid Program provides coverage for rehabilitation services rendered in the Home Health Program. Home Health rehabilitation services include:

1.physical therapy;

2.occupational therapy; and

3.speech/language therapy.

B.All home health rehabilitation services must be medically necessary and prior authorized.



903.Reserved.


A.The Medicaid Program provides reimbursement for physical therapy, occupational therapy and speech/language therapy covered under the Home Health Program.

B.Effective for dates of service on or after February 13, 2014, reimbursement for physical and occupational therapy services shall be 85 percent of the 2013 Medicare published rate. There shall be no automatic enhanced rate adjustment for physical and occupational therapy services.

C.Speech/language therapy services shall continue to be reimbursed at the flat fee in place as of February 13, 2014 and in accordance with the Medicaid published fee schedule for speech/language therapy services provided in the Home Health Program.




Kathy H. Kliebert

Secretary

1409#090




Inpatient Hospital ServicesPublic-Private PartnershipsSouth Louisiana Area(LAC 50:V.1703)

The Department of Health and Hospitals, Bureau of Health Services Financing amends LAC 50:V.1703 in the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This Emergency Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:953(B)(1) et seq., and shall be in effect for the maximum period allowed under the Act or until adoption of the final Rule, whichever occurs first.

The Department of Health and Hospitals, Bureau of Health Services Financing promulgated an Emergency Rule which amended the provisions governing inpatient hospital services to establish supplemental Medicaid payments to non-state owned hospitals in order to encourage them to take over the operation and management of state-owned and operated hospitals that have terminated or reduced services. Participating non-state owned hospitals shall enter into a cooperative endeavor agreement with the department to support this public-provider partnership initiative (Louisiana Register, Volume 38, Number 11). The department promulgated an Emergency Rule which amended the provisions governing reimbursement for Medicaid payments for inpatient services provided by non-state owned major teaching hospitals participating in public-private partnerships which assume the provision of services that were previously delivered and terminated or reduced by a state owned and operated facility (Louisiana Register, Volume 39, Number 4). The department subsequently promulgated an Emergency Rule which amended the provisions governing the reimbursement methodology for inpatient services provided by non-state owned hospitals participating in public-private partnerships to establish payments for hospitals located in the Lafayette and New Orleans areas (Louisiana Register, Volume 39, Number 7).

The department promulgated an Emergency Rule which amended the provisions of the June 24, 2013 Emergency Rule governing inpatient hospital services to remove the provisions governing the cooperative endeavor agreements for Lafayette and New Orleans area hospitals as a result of the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services disapproval of the corresponding State Plan Amendments (Louisiana Register, Volume 40, Number 6). This Emergency Rule is being promulgated to continue the provisions of the June 20, 2014 Emergency Rule. This action is being taken to promote the health and welfare of Medicaid recipients by maintaining recipient access to much needed hospital services.

Effective October 19, 2014, the Department of Health and Hospitals, Bureau of Health Services Financing amends the provisions governing the reimbursement methodology for inpatient hospital services provided by non-state owned hospitals participating in public-private partnerships.

Title 50


Part V. Hospital Services

Subpart 1. Inpatient Hospital Services

Chapter 17.Public-Private Partnerships


A.Reserved.

B.Effective for dates of service on or after April 15, 2013, a major teaching hospital that enters into a cooperative endeavor agreement with the Department of Health and Hospitals to provide acute care hospital services to Medicaid and uninsured patients and which assumes providing services that were previously delivered and terminated or reduced by a state owned and operated facility shall be reimbursed as follows:

1.The inpatient reimbursement shall be reimbursed at 95 percent of allowable Medicaid costs. The interim per diem reimbursement may be adjusted not to exceed the final reimbursement of 95 percent of allowable Medicaid costs.

C.Baton Rouge Area Cooperative Endeavor Agreement

1.The Department of Health and Hospitals (DHH) shall enter into a cooperative endeavor agreement (CEA) with a non-state owned and operated hospital to increase its provision of inpatient Medicaid hospital services by providing services that were previously delivered and terminated by the state-owned and operated facility in Baton Rouge.

2.A quarterly supplemental payment shall be made to this qualifying hospital for inpatient services based on dates of service on or after April 15, 2013. Payments shall be made quarterly based on the annual upper payment limit calculation per state fiscal year. Payments shall not exceed the allowable Medicaid charge differential. The Medicaid inpatient charge differential is the Medicaid inpatient charges less the Medicaid inpatient payments (which includes both the base payments and supplemental payments).

3.The qualifying hospital shall provide quarterly reports to DHH that will demonstrate that, upon implementation, the annual Medicaid inpatient quarterly payments do not exceed the annual Medicaid inpatient charges per 42 CFR 447.271. Before the final quarterly payment for each state fiscal year the quarterly reports will be reviewed and verified with Medicaid claims data. The final quarterly payment for each state fiscal year will be reconciled and will be adjusted to assure that the annual payment does not exceed the allowable Medicaid inpatient charge differential.

4.Inpatient services shall be reimbursed at 95 percent of allowable Medicaid costs. The interim per diem reimbursement may be adjusted not to exceed the final reimbursement of 95 percent of allowable Medicaid costs.

D. - E.3.Repealed.

F. - K.Repealed.




Kathy H. Kliebert

Secretary

1409#091




Intermediate Care Facilities for Persons withIntellectual DisabilitiesPublic FacilitiesReimbursement Rate Increase (LAC 50:VII.32969)

The Department of Health and Hospitals, Bureau of Health Services Financing amends LAC 50:VII.32969 in the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This Emergency Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:953(B)(1) et seq., and shall be in effect for the maximum period allowed under the Act or until adoption of the final Rule, whichever occurs first.

The Department of Health and Hospitals, Bureau of Health Services Financing amended the provisions governing the reimbursement methodology for public intermediate care facilities for persons with developmental disabilities (ICFs/DD), hereafter referred to as intermediate care facilities for persons with intellectual disabilities (ICFs/ID), to establish a transitional Medicaid reimbursement rate for community homes that are being privatized (Louisiana Register, Volume 39, Number 2). This Rule also adopted all of the provisions governing reimbursements to state-owned and operated facilities and quasi-public facilities in a codified format for inclusion in the Louisiana Administrative Code.

The department promulgated an Emergency Rule which amended the provisions governing the transitional rates for public facilities in order to redefine the period of transition (Louisiana Register, Volume 39, Number 10). The department subsequently promulgated an Emergency Rule to assure compliance with the technical requirements of R.S. 49:953, and to continue the provisions of the October 1, 2013 Emergency Rule governing transitional rates for public facilities (Louisiana Register, Volume 40, Number 3). The department promulgated an Emergency Rule which amended the provisions governing the reimbursement methodology for ICFs/ID to increase the add-on amount to the per diem rate for the provider fee (Louisiana Register, Volume 40, Number 3).

Due to an increase in the add-on amount to the per diem rate for the provider fee, the department now proposes to amend the provisions governing the transitional rates for public facilities in order to increase the Medicaid reimbursement rate. This action is being taken to protect the public health and welfare of Medicaid recipients transitioning from public ICFs/ID by ensuring continued provider participation in the Medicaid Program. It is estimated that implementation of this Emergency Rule will increase expenditures in the Medicaid Program by approximately $214,347 for state fiscal year 2014-2015.

Effective October 1, 2014, the Department of Health and Hospitals, Bureau of Health Services Financing amends the provisions governing the reimbursement methodology for public intermediate care facilities for persons with intellectual disabilities.

Title 50


Part VII. Long Term Care

Subpart 3. Intermediate Care Facilities for Persons with Intellectual Disabilities

Chapter 329.Reimbursement Methodology

Subchapter C.Public Facilities

32969.Transitional Rates for Public Facilities

A. - F.4.

G.Effective for dates of service on or after October 1, 2014, the transitional Medicaid reimbursement rate shall be increased by $1.85 of the rate in effect on September 30, 2014.


HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 39:326 (February 2013), amended LR 40:



Kathy H. Kliebert

Secretary

1409#084




Medicaid EligibilityProvisional Medicaid Program(LAC 50:III.2305)

The Department of Health and Hospitals, Bureau of Health Services Financing adopts LAC 50:III.2305 in the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This Emergency Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:953(B)(1) et seq., and shall be in effect for the maximum period allowed under the Act or until adoption of the final Rule, whichever occurs first.

Section 1902(a)(10) of Title XIX of the Social Security Act and Section 435.210 of Title 42 of the Code of Federal Regulations (CFR) provides states with the option to cover individuals under their Medicaid State Plan who are aged or have a disability, and who meet the income and resource requirements for supplemental security income (SSI) cash assistance. These individuals must be referred to the Social Security Administration (SSA) for assistance as there currently is no eligibility category under the Medicaid Program to provide them with Medicaid benefits. Their Medicaid eligibility is contingent upon a favorable decision for SSI cash assistance.

Pursuant to Section 1902(a)(10)of Title XIX of the Social Security Act and 42 CFR 435.210, the Department of Health and Hospitals, Bureau of Health Services Financing promulgated an Emergency Rule which adopted provisions to include this optional coverage group under the Medicaid State Plan by implementing the Provisional Medicaid Program (Louisiana Register, Volume 40, Number 2). This Medicaid program provides interim Medicaid-only benefits to eligible individuals until such time that a decision has been rendered on their SSI cash assistance application pending with the Social Security Administration. This Emergency Rule is being promulgated to continue the provisions of the February 9, 2014 Emergency Rule.

This action is being taken to avoid imminent peril to the health and safety of certain individuals who would have to wait for a Social Security Administration decision to receive Medicaid benefits in order to obtain necessary medical care.Effective October 9, 2014, the Department of Health and Hospitals, Bureau of Health Services Financing hereby adopts provisions to implement the Provisional Medicaid Program.

Title 50

PUBLIC HEALTHMEDICAL ASSISTANCE

Part III. Eligibility

Subpart 3. Eligibility Groups and Factors

Chapter 23.Eligibility Groups and Medicaid Programs

2305.Provisional Medicaid Program

A.The Provisional Medicaid Program provides interim Medicaid-only coverage to individuals who:

1.are aged or have a disability;

2.meet income and resource requirements for supplemental security income (SSI) cash assistance; and

3.have applied for benefits through the Social Security Administration (SSA) and are awaiting a decision on the pending application.

a.Applicants shall have 90 days from the date of Medicaid application to provide proof to the department of a pending application with SSA. If proof of a pending application with SSA is not received timely, after notification by the department has been issued, interim Medicaid benefits shall be terminated.

b.Individuals who would be ineligible for SSI cash assistance due to factors other than excess income and resources or meeting the disability criteria of the program are exempt from the requirement to have a pending application for benefits with the Social Security Administration (SSA).

B.The Provisional Medicaid Program provides coverage to individuals with income equal to or less than the federal benefit rate (FBR), and resources that are equal to or less than the resource limits of the SSI cash assistance program.

C.A certification period for the Provisional Medicaid Program shall not exceed six months, and shall end upon the final decision being rendered on the recipients pending application for benefits through the SSA, whether the outcome is receipt of benefits or denial of benefits due to excess income and resources or not meeting SSAs disability or age criteria.

D.Retroactive coverage up to three months prior to the receipt of the Medicaid application shall be available to recipients in the Provisional Medicaid Program.

1.Any retroactive coverage period shall not be prior to the implementation date of the Provisional Medicaid Program.




Kathy H. Kliebert

Secretary

1409#092




Medical Transportation ProgramEmergency Aircraft TransportationRotor Winged Ambulance Services Rate Increase(LAC 50:XXVII.353)

The Department of Health and Hospitals, Bureau of Health Services Financing amends LAC 50:XXVII.353 in the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This Emergency Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:953(B)(1) et seq., and shall be in effect for the maximum period allowed under the Act or until adoption of the final Rule, whichever occurs first.

In anticipation of a budgetary shortfall in state fiscal year 2013 as a result of the reduction in the states disaster recovery Federal Medical Assistance Percentage (FMAP) rate, the Department of Health and Hospitals, Bureau ofHealth Services Financing amended the provisions governing emergency medical transportation services to reduce the reimbursement rates (Louisiana Register, Volume 40, Number 7). The department now proposes to amend the provisions governing reimbursement for emergency medical aircraft transportation in order to increase the rates for services originating in rural areas.

This action is being taken to promote the health and welfare of Medicaid recipients by ensuring continued access to emergency medical aircraft transportation services. It is estimated that implementation of this Emergency Rule will increase expenditures in the Medicaid Program by approximately $736,644 for state fiscal year 2014-2015.

Effective September 1, 2014, the Department of Health and Hospitals, Bureau of Health Services Financing amends the provisions governing the reimbursement methodology for emergency medical aircraft transportation services to increase the reimbursement rates for rural areas.

Title 50

PUBLIC HEALTHMEDICAL ASSISTANCE

Part XXVII. Medical Transportation Program

Chapter 3.Emergency Medical Transportation

Subchapter C.Aircraft Transportation

353.Reimbursement

A. - H....

I.Effective for dates of service on or after September 1, 2014, the reimbursement rates for rotor winged emergency air ambulance services, which originate in areas designated as rural and/or super rural by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, shall be increased to the following rates:

l.base rate, $4,862.72 per unit; and

2.mileage rate, $33.65 per unit.


HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 35:70 (January 2009), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:2594 (November 2010), amended LR 37:3029 (October 2011), LR 39:1285 (May 2013), LR 40:1379 (July 2014), LR 40:



Kathy H. Kliebert

Secretary

1409#008




Outpatient Hospital ServicesPublic-Private PartnershipsSouth Louisiana Area(LAC 50:V.6703)

The Department of Health and Hospitals, Bureau of Health Services Financing amends LAC 50:V.6703 in the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This Emergency Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:953(B)(1) et seq., and shall be in effect for the maximum period allowed under the Act or until adoption of the final Rule, whichever occurs first.

The Department of Health and Hospitals, Bureau of Health Services Financing promulgated an Emergency Rule which amended the provisions governing outpatient hospital services to establish supplemental Medicaid payments to non-state owned hospitals in order to encourage them to take over the operation and management of state-owned hospitals that have terminated or reduced services (Louisiana Register, Volume 38, Number 11). Participating non-state owned hospitals shall enter into a cooperative endeavor agreement with the department to support this public-private partnership initiative. The department promulgated an Emergency Rule which amended the provisions of the November 1, 2012 Emergency Rule to revise the reimbursement methodology in order to correct the federal citation (Louisiana Register, Volume 39, Number 3). The department promulgated an Emergency Rule which amended the provisions governing the reimbursement methodology for outpatient services provided by non-state owned major teaching hospitals participating in public-private partnerships which assume the provision of services that were previously delivered and terminated or reduced by a state owned and operated facility (Louisiana Register, Volume 39, Number 4). The department promulgated an Emergency Rule which amended the provisions governing the reimbursement methodology for outpatient services provided by non-state owned hospitals participating in public-private partnerships to establish payments for hospitals located in the Lafayette and New Orleans areas (Louisiana Register, Volume 39, Number 7).

The department promulgated an Emergency Rule which amended the provisions of the June 24, 2013 Emergency Rule to remove the New Orleans Area hospital which was erroneously included in these provisions (Louisi

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