BATON ROUGE, La. (AP) — (8/13/19) Louisiana health department leaders Tuesday defended new Medicaid managed care contracts and tried to reassure lawmakers that health plan changes won’t disrupt patient access to services, even as legal disputes threaten to create further complications.
More than a half-million Medicaid recipients will have to transfer to new health plans under the contract changes.
“There’s not going to be an issue where people have no doctors,” Health Secretary Rebekah Gee told the Joint Legislative Committee on the Budget.
But health department lawyer Stephen Russo also acknowledged the new contracts, slated to take effect in January, could be slowed or stalled by challenges from losing bidders for the multibillion-dollar work.
Gov. John Bel Edwards’ administration last week announced the four private companies selected to oversee the care of about 90% of Louisiana’s Medicaid enrollees starting next year. The deals are among the most lucrative in state government, accounting for roughly one-quarter of the state’s annual operating budget.
Almost immediately after the announcement, lawmakers started raising concerns, particularly because the largest current contractor in the program, Louisiana Healthcare Connections, wasn’t chosen to continue the work.
Legislators peppered health department officials with questions Tuesday. Some questioned how the bids were scored, while others fretted about the logistics of shifting 560,000 Medicaid patients to other managed care health plans by January.
“I’m concerned about that transition,” said Sen. Regina Barrow, a Baton Rouge Democrat.
Baton Rouge GOP Sen. Mack “Bodi” White asked how Humana Health Benefit Plan of Louisiana, which hasn’t done Medicaid managed care work in the state, will ramp up a new health plan with a network of doctors, clinics and hospitals available to Medicaid patients.
“I think it’s going to be a tough deal to kick this off,” White said.
Gee replied that Humana is a large national company that already has a network of health care providers in Louisiana through the commercial and Medicare health plans it offers in the state.
“This is not new to them,” she said.
The managed care contracts are similar to the arrangements made in private insurance. The state pays a monthly fee for each person enrolled in a health plan with the companies — mostly adults covered by Medicaid expansion, pregnant women and children. The enrollees get services through a network of primary care doctors, specialists and hospitals.
Current contracts with five companies, negotiated by former Gov. Bobby Jindal’s administration, expire this year.
“No company gets a permanent contract with the state,” Gee said.
Gee and Russo said they weren’t involved in the grading of bid proposals from the six companies that sought the Medicaid work, a review process handled by others in the agency. They said the new contracts are aimed at improving health care and the selection process followed state law’s detailed procurement requirements.
The two losing bidders — Louisiana Healthcare Connections and another current contractor, Aetna Better Health — have until Monday to file a formal protest, Russo said. Louisiana Healthcare Connections already has said it will do so.
The process for handling those protests could lead to a court challenge, which could stop the shift to new contractors at least temporarily. It also could disrupt plans to hold an open enrollment period starting Oct. 15 for Medicaid patients who will lose their existing health plans, Russo said.
When asked what happens if legal protests are ongoing when the new contracts are supposed to start, Russo said the department could seek emergency contracts to try to keep current health plans in place.
“It sure seems like we need to be thinking about what that plan of action might be,” said Sen. Sharon Hewitt, a Slidell Republican. She added: “This is a significant piece of business that’s going to affect 500,000 of our constituents.”
Russo replied: “The gravity of the situation, we understand it.”
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