La. DHH Proposes New Rules to Limit Freestanding Emergency Departments

The Louisiana Department of Health (LDH) published two notices of intent in the July 2016 edition of the Louisiana Register related to free-standing emergency departments (EDs). One proposed rules would prohibit free-standing EDs from operating in Louisiana when they “are not a department of a licensed hospital.” The second proposed rule would require a facility-need review (FNR) process for licensed hospitals that provider emergency services at off-site campuses. The proposed rule would also set limits on the number of beds at these facilities. The rule would require these hospital-based, off-campus EDs to obtain approval through an FNR program before they may be eligible for licensure as part of the hospital. It would also prohibit state officials from approving an application if an applicant does not provide data and other evidence that “effectively establishes the probability of serious, adverse consequences to individuals’ ability to access emergency services if the off-site campus providing emergency services is not allowed to be licensed.” FNR approvals would be non-transferable and expire for off-campus EDs that modify their services or locations. Changes in ownership or location would require resubmission of an FNR application. An FNR approval would also expire if a provider does not obtain final architectural plan approval within 12 months or obtain a license within 24 months. The proposed rule would allow state officials to consider granting a one-time, 90-day extension during this time period, but excludes inappropriate zoning as a valid reason for such an extension. The rule also aims to prevent hospital-based, off-campus EDs from locating outside of a 35-mile radius from a hospital’s main campus, even though the same distance requirement already exists under federal rules as a condition for billing Medicare as a hospital outpatient department.

A public hearing on both proposed rules is scheduled for Thursday, Aug. 25 at 9:30 a.m. in room 118 of the Bienville Building (628 North Fourth Street) in Baton Rouge. Written public comments are due by 4:30 p.m. on Friday, Aug. 26. They can be mailed to Cecile Castello, Health Standards Section, PO Box 3767, Baton Rouge, LA 70821, or submitted by email to MedicaidPolicy@la.gov. (Mike Thompson, mthompson@lhaonline.org)