Louisiana Seeking Increased Guidance On Medicaid Overhaul Plan
Louisiana Department of Health and Hospitals Secretary Alan Levine is seeking further guidance from lawmakers on how to restructure the state's Medicaid program, the Baton Rouge Advocate reports. The 2007 Legislature approved legislation that provides the framework for overhauling Medicaid and is centered on establishing "medical networks of care." Under the plan, the state would oversee managed care networks created by public and private health care providers. Primary care physicians and clinics would provide "medical homes" and refer patients to specialists and hospitals.
Levine said that the law is too broad as written and that he "would be uncomfortable making these broad policy decisions without authority to do it." Levine said, "It's not enough for the Legislature to say provide for a medical home model, accountability for (health care) providers, managed care reimbursement principals. That gives us an awful lot of latitude."
State Sen. Joe McPherson (D), who sponsored the law, said, "How can you argue something is too broad in allowing you to do what you want to do? It was intentionally meant to be broad where you don't preclude moving health care along in the state of Louisiana." The state House on Monday will hold an all-day health care briefing to examine the details of the proposal (Schuler, Baton Rouge Advocate, 11/25).
Gov. Bobby Jindal and Levine write in a New Orleans Times-Picayune opinion piece that their proposal to overhaul Louisiana's Medicaid program will "transform [the program] into an integrated health system for the poor that provides consumers with choice and a medical home; takes an aggressive stand against fraud and abuse; manages chronic disease and decreases emergency room visits; provides incentives for improved health behaviors and expands the number of consumers who have the dignity of health insurance rather than languishing on the roles of the uninsured."
They add that the program needs to be restructured because of "systematic failures." They continue, "We cannot afford to make excuses for having among the highest death rates, highest avoidable hospitalization rates, highest cost and poorest access." Jindal and Levine conclude that the "results and costs" of Medicaid "should be transparent" and that Louisiana residents "will be healthier as a result" (Jindal/Levine, New Orleans Times-Picayune, 11/24).
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