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.

Our Services


EIDR Request

We provide the request form for electronic claims downloads and MR0-14 summaries.

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Physician UPL

View Physician UPL eligibiliy, instructions, downloads, and filing due dates.

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Reduction Factors

View the Medicaid Outpatient Reduction Factors.

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CR Submission

Submission instructions for Medicaid Traditional and Managed Care items.

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FQHC Draft Forms

The FQHC draft cost report forms and change in scope information can be found here.

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Contact Update

View instructions for updating your contact information.

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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. Karen Adams
Louisiana Department of Health
Medicaid Rate Setting and Audit Section
628 North Fourth Street, 7th Floor
Baton Rouge, LA 70821-3797
Office phone# 225-342-0127
Fax# 225-242-0431
email: karen.adams2@la.gov

Secondary Contact Info:

Ms. LaShawn Junius
Louisiana Department of Health
Medicaid Rate Setting and Audit Section
628 North Fourth Street, 7th Floor
Baton Rouge, LA 70821-3797
Office phone# 225-342-3884
Fax# 225-376-4771
email: lashawn.junius@la.gov

Physician UPL Supplemental Payment Program

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 the 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 Physician’s 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 Instructions and Timeline

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. The Timeline Document specifies the program cycle and when submissions will be accepted during the year as well as when payment can be expected. Note that this timeline is subject to change, especially during a rebase year.

Instructions & Clarifications

Program Timelines

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 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.

Form Under Revision

Form Under Revision

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, we can provide a link to our Mimecast server via email. 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

Other useful documents:

LA State Plan Amendment LA FMAP Splits


Feel free to contact Patrice LeBlanc, Brittany Fox, or Heather Gonsoulin at (337) 256-5202.

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 - current 25.44% 74.56%

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) 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:

DRAFT - Cost Reporting forms - DRAFT

Louisiana Medicaid Cost Reporting Forms

Cost Report Forms - Instructions

Change in Scope Forms

Louisiana Change in Scope Form and Instructions

Filing Requirements and Guidelines

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 eight (8) 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
Georgia Chisholm Owner, CPA Email
Bruce Dang Auditor I Email
Alex Davis Retired. Owner, Manager, Senior Auditor Email
Dana Favaro Owner, Senior Auditor Email
Brittany Fox Auditor/Analyst II Email
Heather Gonsoulin Auditor I Email
Linda Huynh Senior Auditor Email
Shannon Johnson Auditor I Email
Mark LeBlanc Auditor I Email
Patrice LeBlanc Owner, Manager, CPA Email
Dawn Robertson Owner, CPA Email
Priscilla Smith Owner, Manager, Senior Auditor Email
Ashley Soelv Auditor I Email
Lindsay Talley Administrative Assistant Email
Alison Williams Owner, Senior Auditor Email