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Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary

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RULE

Department of Health and Hospitals

Bureau of Health Services Financing

Facility Need Review¾Hospice Providers
(LAC 48:I.12503, 12505 and 12526)

The Department of Health and Hospitals, Bureau of Health Services Financing has amended LAC 48:I.12503 and §12505 and has adopted §12526 in the Medical Assistance Program as authorized by R.S. 36:254 and R.S. 40:2116. This Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:950 et seq.

Title 48

PUBLIC HEALTH¾GENERAL

Part I.  General Administration

Subpart 5.  Health Planning

Chapter 125.    Facility Need Review

Subchapter A.   General Provisions

§12503. General Information

A. - C.1. ...

2.     home and community-based service providers, as defined under this Chapter;

3.     adult day health care providers; and

4      hospice providers or inpatient hospice facilities.

D. - F.4.      ...

G.    Additional Grandfather Provision. An approval shall be deemed to have been granted under FNR without review for HCBS providers, ICFs-DD, ADHC and hospice providers that meet one of the following conditions:

1.     ...

2.     existing licensed ICFs-DD that are converting to the proposed Residential Options Waiver;

3.     ADHC providers who were licensed as of December 31, 2009 or who had a completed initial licensing application submitted to the department by December 31, 2009, or who are enrolled or will enroll in the Louisiana Medicaid Program solely as a program for all-inclusive care for the elderly provider; or

4.     hospice providers that were licensed, or had a completed initial licensing application submitted to the department, by March 20, 2012.

H. - H.2. ...

AUTHORITY NOTE:    Promulgated in accordance with R.S. 40:2116.

HISTORICAL NOTE:   Repealed and repromulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 21:808 (August 1995), amended LR 28:2190 (October 2002), LR 30:1483 (July 2004), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 34:2612 (December 2008), amended LR 35:2437 (November 2009), LR 36:323 (February 2010), LR 38:1593 (July 2012).

§12505.   Application and Review Process

A.    FNR applications shall be submitted to the Bureau of Health Services Financing, Health Standards Section, Facility Need Review Program. The application shall be submitted on the forms (on 8.5 inch by 11 inch paper) provided for that purpose, contain such information as the department may require and be accompanied by a nonrefundable fee of $200. An original and three copies of the application are required for submission.

A.1. - B.3.b.       ...

AUTHORITY NOTE:    Promulgated in accordance with R.S. 40:2116.

HISTORICAL NOTE:   Repealed and repromulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 21:812 (August 1995), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 34:2612 (December 2008), amended LR 35:2438 (November 2009), LR 36:323 (February 2010), LR 38:1593 (July 2012).

Subchapter B.      Determination of Bed, Unit, Facility or Agency Need

§12526.     Hospice Providers

A.    No hospice provider shall be licensed to operate unless the FNR Program has granted an approval for the issuance of a hospice provider license. Once the FNR Program approval is granted, a hospice provider is eligible to be licensed by the department, subject to meeting all of the requirements for licensure.

B.    The service area for proposed or existing hospice providers is within a 50 mile radius of the proposed geographic location where the provider is or will be licensed.

C.    Determination of Need/Approval

1.     The department will review the application to determine if there is a need for an additional hospice provider within a 50 mile radius of the proposed geographic location for which the application is submitted.


2.     The department shall grant FNR approval only if the FNR application, the data contained in the application and other evidence effectively establishes the probability of serious, adverse consequences to the recipients’ ability to access hospice care if the provider is not allowed to be licensed.

3.     In reviewing the application, the department may consider, but is not limited to, evidence showing:

a.     the number of other hospice providers within a 50 mile radius of the proposed geographic location servicing the same population; and

b.     allegations involving issues of access to hospice care and services.

4.     The burden is on the applicant to provide data and evidence to effectively establish the probability of serious, adverse consequences to recipients’ ability to access hospice care if the provider is not allowed to be licensed. The department shall not grant any FNR approvals if the application fails to provide such data and evidence.

D.    Applications for approvals of licensed providers submitted under these provisions are bound to the description in the application with regard to the type of services proposed as well as to the site and location as defined in the application. FNR approval of licensed providers shall expire if these aspects of the application are altered or changed.

E.    FNR approvals for licensed providers are non-transferrable and are limited to the location and the name of the original licensee.

1.     A hospice provider undergoing a change of location within a 50 mile radius of the licensed geographic location shall submit a written attestation of the change of location and the department shall re-issue the FNR approval with the name and new location. A hospice provider undergoing a change of location outside of the 50 mile radius of the licensed geographic location shall submit a new FNR application and fee and undergo the FNR approval process.

2.     A hospice provider undergoing a change of ownership shall submit a new FNR application to the department’s FNR Program. FNR approval for the new owner shall be granted upon submission of the new application and proof of the change of ownership, which must show the seller’s or transferor’s intent to relinquish the FNR approval.

3.     FNR approval of a licensed provider shall automatically expire if the hospice agency is moved or transferred to another party, entity or location without an application being made to, and approval from, the FNR Program.

AUTHORITY NOTE:    Promulgated in accordance with R.S. 40:2116.

HISTORICAL NOTE:   Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 38:1593 (July 2012).

 

Bruce D. Greenstein

Secretary

1207#118

 

 LA REGISTER VOL 38, NO 07 JULY 20, 2012