SUBPART B. HEALTHCARE PROVIDERS
UPPER PAYMENT LIMIT FINANCING METHODOLOGY
§1243.1. Healthcare providers; upper payment limit
A. Subject to appropriation, the Louisiana Department of Health may develop and
maintain a Medicaid upper payment limit financing methodology which incorporates any
healthcare provider licensed by the Louisiana Department of Health. The purpose of
developing an upper payment limit financing methodology is to enhance the delivery of
healthcare services to the uninsured and Medicaid patients. Any such upper payment limit
financing methodology shall be in accordance with federal law and subject to approval by
the Centers for Medicare and Medicaid Services.
B. The department may submit waivers or state plan amendments to the Centers for
Medicare and Medicaid Services in order to secure federal financial participation in relation
to any such upper payment limit financing methodology. Disbursements of monies generated
by the use of an upper payment limit methodology shall be made only in accordance with an
approved waiver or state plan amendment.
Acts 2011, No. 310, §1, eff. June 28, 2011; Redesignated from R.S. 40:1300.331 by
HCR 84 of 2015 R.S; Acts 2018, No. 206, §4.