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Program B: Payments to Public Providers

PROGRAM DESCRIPTION

The mission of the Payments to Public Providers Program is to provide payments to public providers of health care services to Louisiana residents who are eligible for Title XIX (Medicaid) and to administer the Medicaid Program to ensure operations are in accordance with federal and state statues regarding medically necessary services to eligible recipients. Additionally, the Medical Vendor Payments Program assures that reimbursements to providers of medical services to Medicaid recipients are appropriate.

The goal of the Payments to Public Providers Program is to screen children for medical, vision, hearing and dental abnormalities.

The Payments to Public Providers Program provides for direct payments to the following: Louisiana Health Care Authority, LSU Medical Center, State MR/DD Services, State Long Term Care Facilities, Office of Public Health, Office of Substance Abuse, Community Mental Health, Public Psychiatric Free Standing Units, Public Psychiatric Distinct Part Units, State Education, and other public providers.

The Payments to Public Providers Program administers the KIDMED program. KIDMED is Louisiana's name for the federally mandated service that must be offered to economically disadvantaged children under the State's Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program. Federal legislation established EPSDT as a Medicaid service in 1967. Louisiana began providing EPSDT when it became a mandatory service in 1972. In 1990, Louisiana renamed the screening component of its EPSDT program to KIDMED.

 

OBJECTIVES AND PERFORMANCE INDICATORS

Unless otherwise indicated, all objectives are to be accomplished during or by the end of FY 1999-2000. Performance indicators are made up of two parts: name and value. The indicator name describes what is being measured. The indicator value is the numeric value or level achieved within a given measurement period. For budgeting purposes, performance indicator values are shown for the prior fiscal year, the current fiscal year, and alternative funding scenarios (continuation budget level and Executive Budget recommendation level) for the ensuing fiscal year (the fiscal year of the budget document).

 

RESOURCE ALLOCATION FOR THE PROGRAM

SOURCE OF FUNDING

This program is funded with General Fund, Interagency Transfers, Fees and Self-generated Revenues, Statutory Dedications, and Federal Funds. The Interagency Transfers are derived from the pooling of Medicaid collections from various agencies in the Department of Health and Hospitals and the LSU Health Care Services Division (LSU-HCSD). The Self-generated Revenues in the existing operating budget base derive from prior years' over collections in the LSU-HCSD facilities and the DHH Inpatient Mental facilities. The Statutory Dedication, also only in the existing operating budget, is the Louisiana Medical Assistance Trust Fund which derives its funding source from the collection of provider fees from varying medical providers in the state based on corresponding per bed per day rates. (Per R.S. 39:32B.(8), see table below for a listing of expenditures out of each statutory dedicated fund.) Federal Funds represent federal financial participation in the Medicaid program.

ANALYSIS OF RECOMMENDATION

GENERAL FUND

TOTAL

T.O.

DESCRIPTION

 

 

 

 

 

$109,525,795

$384,772,248

0

 

ACT 19 FISCAL YEAR 1998-1999

 

 

 

 

 

 

 

 

 

BA-7 TRANSACTIONS:

$0

$244,093

0

 

This BA-7 increased the reimbursement rate paid to nursing homes across the state. Th state match was provided by an increase in the provider fees all nursing homes pay per bed per day to the Department of Health and Hospitals.

 $0

 $0

 0

 

This BA-7 substituted $500,000 in self-generated revenue for interagency transfers to provide the $500,000 in interagency transfers to the New Orleans Adolescent Hospital for capital project. 

$0

$0

0

 

This BA-7 properly aligned the means of financing in this program by increasing statutory dedications and decreasing interagency transfers by $637,269. This increase is anticipated statutory dedications is not related to the previous BA-7.

         

$109,525,795

$385,016,341

0

 

EXISTING OPERATING BUDGET – November 20, 1998

 

 

 

 

 

($786,712)

($2,651,541)

0

Other Adjustments - An adjustment to balance to the anticipated utilization of Title XIX in the budgets of varying public agencies

($629,736)

$0

0

Means of Financing Substitution(s) - Replace general fund with federal funds in response to the change in the Federal Medical Assistance Percentage from 29.71% in FY 1999 to 29.67% in FY 2000 the need to properly align the revenue base in the program

$720,089

$0

0

Means of Financing Substitution(s) - Replace interagency transfers with general fund to correctly align of the means of financing in across the four program

$3,571,445

$0

0

Means of Financing Substitution(s) - Replace $3,571,445 in statutory dedications and $500,000 in self-generated revenues with $3,571,445 in general fund and $500,000 in interagency transfers to remove all nonrecurring revenue from the means of financing base

 

 

 

 

 

$112,400,881

$382,364,800

0

 

TOTAL RECOMMENDED

 

 

 

 

 

$2,875,086

($2,651,541)

0

 

DIFFERENCE (TOTAL RECOMMENDED AND EXISTING OPERATING BUDGET)

The total means of financing for this program is recommended at 99.3% of the existing operating budget. It represents 93.4% of the total request ($409,286,536) for this program. The only substantive change to this program is the balancing of this program's budget to the expenditures budgeted in the various public agencies which are reimbursable under applicable law in Medicaid claims. The increase in general fund is due to the means of financing substitution removing the $3.6 million of nonrecurring revenue from the base.

PROFESSIONAL SERVICES

This program does not have funding for Professional Services for Fiscal Year 1999-2000.

OTHER CHARGES

 

Interagency Transfers for the payments to following public providers for the provision of wide variety of medical services to patients enrolled in the State’s Medicaid program:

 $670,352

Capital Area Human Services District

$56,000

Louisiana School for the Deaf

$5,025,564

Louisiana Special Education Center

$6,586,273

Local education agencies

$62,113,798

Louisiana State University Medical Center (LSUMC)

$106,212,105

LSUMC, Health Care Services Division

$5,148,316

New Orleans Home and Rehabilitation Center

$154,307,396

Office of Citizens with Developmental Disabilities

$6,748,299

Office of Mental Health

$15,057,894

Office of Public Health

$794,612

Office of Alcohol and Drug Abuse

$1,006,710

 

Other Varying Public Agencies

$4,812,370

 

Special School District #1

$13,825,111

 

Villa Feliciana Medical Complex

 

 

 

$382,364,800

 

TOTAL INTERAGENCY TRANSFERS

ACQUISITIONS AND MAJOR REPAIRS

This program does not have funding for Acquisitions and Major Repairs for Fiscal Year 1999-2000.


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