UPPER PAYMENT LIMIT FINANCING METHODOLOGY §1243.1. Healthcare providers; upper payment limit A. Subject to appropriation, the Louisiana Department of Health may develop and maintain a Medicaid upper payment limit financing methodology which incorporates any healthcare provider licensed by the Louisiana Department of Health. The purpose of developing an upper payment limit financing methodology is to enhance the delivery of healthcare services to the uninsured and Medicaid patients. Any such upper payment limit financing methodology shall be in accordance with federal law and subject to approval by the Centers for Medicare and Medicaid Services. B. The department may submit waivers or state plan amendments to the Centers for Medicare and Medicaid Services in order to secure federal financial participation in relation to any such upper payment limit financing methodology. Disbursements of monies generated by the use of an upper payment limit methodology shall be made only in accordance with an approved waiver or state plan amendment.
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