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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 eligible for Title XIX (Medicaid).

The goal of the Payments to Public Providers program is to provide 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.

Payments to Public Providers 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

1. In FY 1998-99, the Payments to Public Providers Program will ensure that 94% of eligible recipients (Medicaid eligibles from birth through 20 years of age) are enrolled in the KIDMED Program and receive available services through outreach efforts.

1 The reported data is on a Federal Fiscal Year basis. Eighty-five percent is the federal goal.

RESOURCE ALLOCATION FOR THE PROGRAM

SOURCE OF FUNDING

 

This program is funded with general fund, interagency transfers, statutory dedications, and federal funds. The interagency transfers are derived from the Department of Education, Office of Special Education for CHILDNET case management and the Department of Social Services, Office of Family Support for refugee Medical Vendor payments. The statutory dedication is the Louisiana Medical Assistance Trust Fund that is funded from provider fees. (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

 

 

 

 

 

$120,137,098

$409,676,562

0

 

ACT 18 FISCAL YEAR 1997-1998

 

 

 

 

 

 

 

 

 

BA-7 TRANSACTIONS:

$0

$0

0

 

None

 

 

 

 

 

$120,137,098

$409,676,562

0

 

EXISTING OPERATING BUDGET - December 10, 1997

 

 

 

 

 

$286,774

$0

0

 

Means of Financing Substitution(s) - Replace federal funds with general fund for the Federal Medical Assistance Percentage (FMAP) change in the state match rate from 29.64% to 29.71%

($1,009,230)

$0

0

 

Means of Financing Substitution(s) - Replace general fund with statutory dedications to adjust budget for additional requests made by the Department of Health and Hospitals

($8,918,447)

($30,018,332)

0

 

Adjustment(s) to balance to the public agencies' budgets

($2,370,400)

($8,000,000)

0

 

Adjustment(s) to transfer funds to the Uncompensated Care Costs program to more accurately reflect the sources of revenue for the LSU Medical Center

$0

$100,000

0

 

Adjustment(s) to restore funding to the New Orleans Home and Rehabilitation Center

$0

$394,695

0

 

Adjustment(s) to restore funding to the Southwest Developmental Center

$0

$4,519,424

0

 

Adjustment(s) to restore funding agency wide to the Office for Citizens with Developmental Disabilities

$1,400,000

$8,099,899

0

 

Adjustment(s) to provide funding to the Office for Citizens with Developmental Disabilities to address areas of concern raised by the U.S. Department of Justice Inquiry

 

 

 

 

 

 

 

 

 

 

$109,525,795

$384,772,248

0

 

TOTAL RECOMMENDED

 

 

 

 

 

($10,611,303)

($24,904,314)

0

 

DIFFERENCE (TOTAL RECOMMENDED AND EXISTING OPERATING BUDGET)

The total means of financing for this program is recommended at 93.9% of the existing operating budget. It represents 96.5% of the total request ($398,851,230) for this program. The major changes are adjustments to balance this budget to the budgets of the public agencies utilizing Medicaid and the various funding increases for the Office for Citizens with Developmental Disabilities.

PROFESSIONAL SERVICES

This program does not have funding for Professional Services for Fiscal Year 1998-1999.

OTHER CHARGES

 

 

Interagency Transfers:

$108,026,423

 

Medicaid payments to the Health Care Services Division of the LSU Medical Center for non-discretionary inpatient & outpatient hospital services

$28,868,771

 

Medicaid payments to the LSU Medical Center for non-discretionary inpatient & outpatient hospital services

$24,630,380

 

Medicaid payments to the LSU Medical Center for non-discretionary physician services

$162,055,643

 

Medicaid payments to the Office of Mental Retardation for discretionary ICF/MRs (residential facilities for the mentally retarded)

$19,600,637

 

Medicaid payments to Villa Feliciana Chronic Disease Hospital and New Orleans Home & Rehabilitation Center for non-discretionary nursing home services

$13,689,030

 

Medicaid payments to the Office of Public Health for non-discretionary EPSDT and family planning services, and various other services

$794,612

 

Medicaid payments to the Office of Substance Abuse for discretionary alcohol and substance abuse outpatient clinics

$5,763,758

 

Medicaid payments to local education agencies for non-discretionary school based health services

$4,536,384

 

Medicaid payments to the Office of Mental Health for discretionary community mental health services

$8,091,088

 

Medicaid payments to the Office of Mental Health for non-discretionary inpatient mental hospital services in free standing units

$7,974,800

 

Medicaid payments to the Health Care Services Division of the LSU Medical Center for non-discretionary inpatient mental hospital services in distinct part units

$740,722

 

Medicaid payments to other public agencies for non-discretionary services

 

 

 

$384,772,248

 

TOTAL INTERAGENCY TRANSFERS

ACQUISITIONS AND MAJOR REPAIRS

This program does not have funding for Acquisitions and Major Repairs for Fiscal Year 1998-1999.


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