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Providers press for nursing billing code and disability-services fund dollars; figures in testimony vary
Summary
Advocates and providers told the committee LDH needs funding to request a nursing billing code for DD waivers and proposed using the Disability Services Fund; witnesses cited a $2.4 million appropriation request and larger cost estimates LDH previously provided.
Kelly Monroe, executive director of The Arc of Louisiana, and representatives of disability provider agencies testified that Medicaid-DD waiver providers need a new billing code to allow agencies to bill separately for nursing services. They asked the Finance Committee to consider funding the request from the Disability Services Fund.
Monroe said the Arc and partners had pursued study resolutions and code requests in prior sessions and that LDH previously said a means of finance was required before CMS could approve a billing code. “We were able to get some, medical marijuana money in there, and then also some gaming money, and right now it's at 13,000,000,” a witness told the committee when asked about the fund’s balance.
Witnesses described two different dollar figures in the public record. Caroline Meehan earlier mentioned a supplemental ask “for about $2,400,000 in, from the disability services fund which would support nursing services in the home and community based waivers.” Later testimony, including references to LDH cost reports and CMS processes, cited larger cost estimates to implement a billing code; one figure given in committee discussion was about $32,300,000 (rounding and transcript wording varied between $32,300,000 and $32,388,000 in witness remarks).
Ramona Kidd of ARCO and other providers stressed that nursing oversight is a daily operating expense for provider agencies: “This is a extraordinary responsibility. We handle it well,” she said, and argued that nurses “don’t work for charity.” Providers said the Nursing code would allow separate billing for nursing services and that federal approval would require proof of a financing mechanism.
Kelly Monroe and other witnesses proposed using the Disability Services Fund as one mechanism; they said the fund currently contains the proceeds of prior designations (medical marijuana and gaming receipts) and could support a multi-year plan. Committee members asked for composition and deposit details and asked witnesses to provide documentation for matching and timing.
Ending: The committee requested precise cost reports, LDH filings and the Disability Services Fund deposit history to evaluate whether the smaller $2.4 million, the larger $32+ million estimate, or a phased approach is appropriate.
