The Associated Press

BATON ROUGE -- The Louisiana Department of Health and Hospitals, in response to cuts ordered when the Legislature crafted the state budget earlier this year, outlined Wednesday how it plans to reduce its spending by $20 million.

Most of the cuts will come in Medicaid money going to private health-care providers for taking care of the poor and disabled.

Certain types of nurses and anesthesiologists will see a reduction in their fees. Delivery fees won't be paid for medical equipment. Out-of-state hospitals will get smaller payments for treating Louisiana's Medicaid patients. And private group homes for the developmentally disabled will get fewer Medicaid dollars.

The Department of Health and Hospitals has been looking at how to reduce $5 million in state Medicaid spending -- or about $20 million total with federal matching dollars -- since the budget period began July 1.

The amount is a relatively minor figure in the department's multibillion-dollar budget and is substantially less than the original projections for the agency, where lawmakers once predicted up to $1 billion could be cut.

The bulk of the reductions to the Medicaid program for the poor and disabled -- about $16.7 million -- will hit the private providers, including hospitals, nurses, community homes for the mentally retarded, doctors, nursing homes and mental health rehabilitation services.

The nursing home reduction isn't actually a cut. It shrinks the amount of an increase that had been given to the nursing homes, according to the department and the Louisiana Nursing Home Association.

The public health and developmental disabilities offices take the rest of the cut, about $3.4 million. But the department said that can be absorbed ``by belt-tightening and should not severely impact services.'