LAC 50:V.5109
LAC 50:V.5109. Children's Specialty Hospitals
Cite as La. Admin. Code tit. 50, pt. V, § 5109
A. In order to receive Medicaid reimbursement for outpatient services as a children’s specialty hospital, the acute care hospital must meet the following criteria:
1. be recognized by Medicare as a prospective payment system (PPS) exempt children's specialty hospital;
2. does not qualify for Medicare disproportionate share hospital payments; and
3. has a Medicaid inpatient days utilization rate greater than the mean plus two standard deviations of the Medicaid utilization rates for all hospitals in the state receiving Medicaid payments.