LeBlanc, Robertson, Chisholm and Associates, LLC

Formerly known as Cypress Audit Team. We are the audit contractor for the Louisiana Medicaid Hospital, Mental Health, and RHC programs. We also assist in the calculations of Ambulance and Physician UPL supplemental payments. We hope that this website will provide you with valuable information to assist your needs. Please click below to view our services and resources.

Electronic Information Data Request (EIDR)

Your Louisiana Medicaid claims and revenue raw data may be obtained in an electronic text format by requesting the information from the Louisiana Department of Health. Below is the primary and secondary contact information and the request form. We have also included the form needed to request an MR0-14 summary report:

Download:

EIDR MR0-14

Primary Contact Info:

Ms. Sabrina Scott
Louisiana Department of Health
Rate Setting and Audit Section
628 North Fourth Street, Bienville Building
Baton Rouge, LA 70802
Office phone# 225-342-9475
Fax# 225-389-2688
email: sabrina.scott2@la.gov

Secondary Contact Info:

Ms. Patnisha Williams
Louisiana Department of Health
Rate Setting and Audit Section
628 North Fourth Street, Bienville Building
Baton Rouge, LA 70802
Office phone# 225-342-9475
Fax# 225-389-2688
email: Patnisha.Williams@la.gov

Physician Fee for Service UPL Supplemental Payments

The Louisiana Department of Health has been approved by the Centers for Medicare and Medicaid Services (CMS) to make payments in the Physician's Supplemental Payment Program for all of the entities noted in the LA State Plan Amendment. The purpose of this program is to enhance payments to physicians employed or contracted by the public hospitals. Below are the requested forms and instructions necessary to participate in this program.

Note: In accordance with the Physicians Supplemental Payment Program State Plan Amendment, average commercial to Medicare conversion factors must be updated every three years. Billing numbers with expired conversion factors must complete an updated LA Commercial Data Request Form with updated commercial rate information.

Program Due Dates and Timeline

Please refer to the Timeline for an overview of the Program Cycles, submission due dates, and payment dates.

Program Timelines


Fee For Service [FFS] Program

Please review the instruction documents prior to completing the submission forms. The Instruction documents outline the recommended approach to completing your submission as well as clarifications for frequently asked questions and examples.

FFS Instructions & Clarifications

[FFS] UPL Submission Forms

Each submission must include completed LA Commercial Data Request and Certification Forms. These forms will need to be submitted annually to maintain eligibility within the Fee for Service [FFS] UPL program.

LA Commercial Data Request Form: The Practitioner Information and Submission Checklist tabs will need to be filed annually, while the Average Commercial Rate forms are filed on initial submission and then once every 3 years. Submission of these forms will only maintain eligibility under the FFS Program.

FFS LA Commercial Data Request Form

FFS LA Certification Form

Physician Disclosure

Please submit completed forms to LDH at: PhysicianUPL@LA.GOV

If your submission contains sensitive information and you need a secure portal to submit through, please contact us. If you prefer to submit by mail, our physical location is:

LeBlanc, Robertson, Chisholm and Associates, LLC
attn: Physician UPL
2008 Belle Place Olivier Rd.
New Iberia, LA 70563
ph# 225-256-5202

Feel free to contact Brittany Fox at (337) 256-5202 with any questions or concerns.



Physician Full Medicaid Pricing [FMP]

The Louisiana Department of Health is gathering applications for a potential extension for currently participating FMP physician groups. For consideration, please submit applicable forms no later than March 15, 2024.

Submission Forms

FMP Physician Data Form

For all current participants who have not filed for FFS SFY 2023, please complete the form below.

LA Commercial Data Request


FMP Certification Form

To maintain your FMP participation, please complete the form below.

FMP Certification Form


FMP Instructions & FAQ

Submit completed forms to LDH: PhysicianUPL@LA.GOV

Feel free to contact Brittany Fox at (337) 256-5202 with any questions or concerns.

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Outpatient Reduction Factors

Urban and Non-Eligible Rural Hospitals

Period Reduction Factor Payment
Prior to August 1, 2006 17.00% 83.00%
August 1, 2006 - February 19, 2009 13.80% 86.20%
February 20, 2009 - August 3, 2009 16.82% 83.18%
August 4, 2009 - February 2, 2010 21.52% 78.48%
February 3, 2010 - July 31, 2010 25.44% 74.56%
August 1, 2010 - December 31, 2010 28.87% 71.13%
January 1, 2011 - July 31, 2012 30.29% 69.71%
August 1, 2012 - January 31, 2013 32.87% 67.13%
February 1, 2013 - December 31, 2016 33.54% 66.46%
January 1, 2017 - December 31, 2017 28.87% 71.13%
January 1, 2018 - December 31, 2018 25.44% 74.56%
January 1, 2019 - December 31, 2019 16.82% 83.18%
January 1, 2020 - Current 14.16% 85.84%

Eligible Rural Hospitals

Period Reduction Factor Payment
Prior to August 1, 2006 17.00% 83.00%
August 1, 2006 - June 30, 2008 13.80% 86.20%
July 1, 2008 - current 00.00% 110.00% (Excluding Clinical Lab at fee schedule)

Federally Qualified Health Centers (FQHC) and Rural Health Clinic (RHC) Change in Scope forms

The following forms should be used when requesting a change in your Medicaid prospective rate per visit due to a change in scope of services:

FQHC and RHC FIling Requirements and Guidelines

Change in Scope Requirements and Guidelines



Rural Health Centers (RHC)

LA Change in Scope Form and Instructions


Federally Qualified Health Centers (FQHCs)

LA Change in Scope Form and Instructions

LA Medicaid Cost Report Form

LA Medicaid Cost Report Form Instructions

LeBlanc, Robertson, Chisholm and Associates (LRCA), LLC, formerly Cypress Audit Team, LLC, is a Louisiana based company of professionals engaged to perform the review work of Medicaid Hospital and Rural Health Clinic (RHC) cost reports. The company began operations in July 2009 by a group of co-workers who were former employees of the Louisiana Medicare/Medicaid fiscal intermediary. LRCA owner’s consists of six (6) members, including three (3) certified public accountants. In January 2014, the company became a licensed certified public accounting firm which prompted our name change. LRCA members are well versed in the healthcare field. We have extensive experience managing large Medicaid and Medicare workloads, meeting timeliness and quality standards established by the contracting agency. We have an established relationship with the Louisiana providers and their representatives. Over the years we have acquired a reputation for fairness and accuracy in the provider community.

Contact Us!

PHYSICAL LOCATION:

LeBlanc, Robertson, Chisholm and Associates, LLC
Attn: Ms. Priscilla Smith
5555 Hilton Avenue, Suite 605
Baton Rouge, LA 70808


PHONE:
225.218.6242


FAX:
225.246.8767
Wendy Blaine Auditor I Email
Brooke Bodin Auditor I Email
Georgia Chisholm, CPA Owner, Senior Auditor Email
Bruce Dang Auditor I Email
Billy Dudley Auditor I Email
Dana Favaro Owner, Senior Auditor Email
Brittany Fox Senior Auditor Email
Linda Huynh Senior Auditor Email
Shannon Johnson Auditor I Email
Mark LeBlanc Auditor I Email
Patrice LeBlanc, CPA Owner, Manager Email
Dawn Robertson, CPA Owner, Manager Email
Priscilla Smith Owner, Manager Email
Lindsay Talley Administrative Assistant Email
Alison Williams Owner, Senior Auditor Email