RS 2197 - Licensure of rural health clinics
A. In order to receive certification by the Health Care Financing Administration, or its successor, and designated reimbursement for any rural health clinic service under Medicaid or Medicare, a rural health clinic, as defined herein, shall be licensed as such by the Louisiana Department of Health. Designated Medicaid reimbursement for any service as a rural health clinic in the state, which is not licensed as such, is prohibited.
B. The department shall prescribe and publish minimum standards, rules, and regulations as necessary to effectuate the provisions of this Section. Such rules and regulations shall include but not be limited to all of the following:
(1) Operational and personnel requirements.
(2) Practice standards to assure quality of care.
(3) Licensure application procedures and requirements.
(4) Initial and annual renewal of license investigations.
(5) Complaint investigations.
(6) Reimbursement policies, procedures, and requirements.
(7) Denial, revocation, and nonrenewal of licenses and the appeals thereof.
C. A license issued under the provisions of this Part is not transferrable or assignable between persons, rural health clinics, or both.
D. For purposes of this Part, a "rural health clinic" means a facility which is engaged in furnishing primary health services to outpatients by physicians, physician assistants, or nurse practitioners, including but not limited to health services related to family medicine, internal medicine, pediatrics, obstetrics, and gynecology, and such services and supplies incident thereto. Such facility shall be located in an area that is not an urbanized area, as defined by the Bureau of the Census, in which there are insufficient numbers of needed healthcare practitioners, as determined by the secretary of the United States Department of Health and Human Services, and which has been determined to be a rural health clinic by the secretary of that department under 42 U.S.C. 1395aa(a).
E. Nothing in this Part shall restrict the ability of any private physician to receive reimbursement under Medicaid or Medicare for services provided other than rural health clinic services.
F.(1) No provision of this Part, or any rule or regulation adopted pursuant thereto, restricting location of a rural health clinic shall apply to an applicant for licensure as a rural health clinic if the applicant or a related entity agreed to establish such clinic as part of an agreement providing for the sale or transfer of a hospital service district hospital approved by the electorate of the district prior to July 1, 1997.
(2) A rural health clinic described in Paragraph (1) of this Subsection shall not be required to be licensed by the state in order to receive certification as a rural health clinic by the Health Care Financing Administration, or its successor, for a period of one year after July 15, 1997.
G. Notwithstanding the provisions of Subsection A of this Section to the contrary, a rural health clinic that meets the definition of the Health Care Financing Administration, or its successor, as hospital-based and is operated by a rural hospital as defined in R.S. 40:1189.3 shall not be required to secure a separate license to receive certification by the Health Care Financing Administration, or its successor, and designated reimbursement under Medicaid and Medicare as long as the rural hospital meets state licensure requirements. Such hospital shall assure that the clinic meets all other requirements of this Section, as well as any pursuant rules and regulations promulgated by the Louisiana Department of Health pertaining to rural health clinics. The provisions of this Subsection shall only become effective if and when the Louisiana Department of Health receives a determination from the Health Care Financing Administration, or its successor, that rural health clinic services are considered outpatient hospital services and eligible for uncompensated care costs reimbursement only if the rural health clinic services are not performed in a separately licensed facility.
Acts 1997, No. 1333, §1, eff. July 15, 1997; Acts 1999, No. 1279, §1; Acts 2004, No. 36, §1; Acts 2018, No. 206, §4.