HB 198

ENROLLED
 2026 Regular Session
  ACT No. 626
 HOUSE BILL NO. 198
 BY REPRESENTATIVE ECHOLS AND SENATORS BARROW, JACKSON-
  ANDREWS, AND JENKINS AND REPRESENTATIVE CHASSION
1AN ACT
2 To enact R.S. 46:452, relative to ambulatory surgical centers; to provide for Medicaid
3reimbursement rates; to provide for a reimbursement rate plan; to provide for
4implementation; to provide for a deadline; to authorize the Louisiana Department of
5Health to promulgate rules; to provide for implementation; to provide for an
6effective date; and to provide for related matters.
7 Be it enacted by the Legislature of Louisiana:
8Section 1. R.S. 46:452 is hereby enacted to read as follows:
9§452. Medicaid ambulatory surgical center reimbursement plan; Medicare rate
10comparability
11A.(1) The Louisiana Department of Health shall develop and implement a
12plan for increased Medicaid managed care organization reimbursement rates and
13fee-for-service reimbursement rates for gastroenterology, dental ophthalmology,
14dental and otolaryngology procedures conducted at ambulatory surgical centers.
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 HB NO. 198  ENROLLED
1(2) The reimbursement rate established pursuant to this Section shall be the
2lesser of the following:
3(a) The rate paid for the same or similar procedure in an outpatient hospital
4setting.
5(b) One hundred percent of the Medicare rate for the same or similar
6procedure.
7(3) The plan shall include procedure codes utilized for gastroenterology,
8ophthalmology, dental and otolaryngology procedures conducted at ambulatory
9surgical centers and the estimated cost of implementation of the plan.
10B. The Louisiana Department of Health shall take all necessary actions to
11annually update the reimbursement rates for gastroenterology,  dental,
12ophthalmology, and otolaryngology procedures conducted at ambulatory surgical
13centers in accordance with the methodology provided in Subsection A of this
14Section.
15C. The Louisiana Department of Health shall submit the plan required by this
16Section to the Senate Committee on Health and Welfare, the Senate Committee on
17Finance, the House Committee on Health and Welfare, and the House Committee on
18Appropriations no later than October 1, 2026.
19D. Not later than October 1, 2026, the Louisiana Department of Health shall
20take all necessary actions, including but not limited to filing any Medicaid state plan
21amendment required by the Centers for Medicare and Medicaid Services, to
22implement the provisions of this Section.
23E. The Louisiana Department of Health shall promulgate all rules and
24regulations in accordance with the Administrative Procedure Act as are necessary to
25implement the provisions of this Section.
26Section 2. Not later than October 1, 2026, the Louisiana Department of Health shall
27 take all necessary actions including but not limited to filing a Medicaid state plan
28 amendment, to implement the provisions of Section 1 of this Act.
29Section 3. The implementation of the provisions of this Act shall be subject to the
30 appropriation of funds by the legislature for this purpose.
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HB NO. 198  ENROLLED
1Section 4. This Act shall become effective upon signature by the governor or, if not
2 signed by the governor, upon expiration of the time for bills to become law without signature
3 by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If
4 vetoed by the governor and subsequently approved by the legislature, this Act shall become
5 effective on the day following such approval.
  SPEAKER OF THE HOUSE OF REPRESENTATIVES
  PRESIDENT OF THE SENATE
  GOVERNOR OF THE STATE OF LOUISIANA
APPROVED:
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