LA HCR3

Establishes a hospital stabilization formula under Louisiana Constitution Article VII, Section 10.13, authorizing the Louisiana Department of Health to levy quarterly assessments on hospitals once CMS approves a directed payment arrangement for inpatient and outpatient services.

Sets FY 2026-2027 assessment rates based on net patient revenue: 1.38% for long-term acute care, psychiatric, and rehabilitation hospitals; 4.99% for non-rural Hospital Service Districts (on revenue up to $125 million); 6.49%/6.74% for other acute care hospitals (on revenue up to $125 million); and 2.36% on revenue exceeding $125 million.

Exempts rural hospitals (per R.S. 40:1189.1), non-rural small urban private acute hospitals with 40 beds or fewer, and freestanding psychiatric Medicaid disproportionate share hospitals from the assessment.

Requires reimbursement enhancements including directed payment arrangements submitted to CMS by May 31, 2026, continuation of Medicaid expansion to maximize federal matching funds, and hospital reimbursement rates no less than those in effect as of January 1, 2026.

Mandates LDH publish quarterly reports within 30 days detailing Medicaid claims paid by hospital, directed payments received, and supplemental payments, and requires state plan amendments be submitted to CMS within 120 days of adoption.