BATON ROUGE, La. (AP) — Louisiana lawmakers are pushing for more oversight of Gov. Bobby Jindal's plan to turn over much of the state's Medicaid program to private insurance companies.
The House on Monday unanimously backed a proposal that would require the so-called "coordinated care networks" to end on Dec. 31, 2014, unless they receive legislative reauthorization. It also would require detailed reporting to lawmakers about whether shifting Medicaid to a managed care program results in savings or increased claims rejections for patients.
The coordinated care networks will change the way the state spends billions of Medicaid dollars, changing it largely to an insurance-based model. The combined state-federal program serves the poor, elderly and disabled.
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"I think it's important that in the process the Legislature maintain some oversight," said House Speaker Jim Tucker, R-Terrytown. "While I expect it's going to be a successful program, and I think it's something we probably need to do for financial reasons, I think we need to be able to review it."
The oversight measure heads back to the Senate for approval of House changes. Several lawmakers have said they expect Jindal to veto the proposal if it reaches his desk, though the governor has not openly threatened such action.
"We're watching the bill through the process," said Jindal spokesman Kyle Plotkin.
The planned Medicaid changes have run into concerns from health providers and lawmakers. Jindal unveiled the plan more than two years ago, but it has yet to begin. It is slated to start in the upcoming fiscal year that begins July 1.
Hundreds of thousands of low-income residents who get medical treatment through Medicaid, mostly children, would be steered into the managed care networks. The networks would be run by private companies that contract with the state and negotiate payments with health providers. The coordinated care networks are expected to take about two-thirds of the state's 1.2 million Medicaid recipients when fully phased in.
Currently, the state reimburses doctors, hospitals and other providers in the Medicaid program directly, giving a flat fee for each service rendered.
The Jindal administration said the new program would better coordinate care for Medicaid recipients, improve health outcomes by catching and treating chronic diseases earlier, and help rein in rising costs due to Medicaid fraud and overuse of expensive emergency room care. Many other states use a similar model.
Health providers have worried that the managed care companies will be slower to pay claims or cause administrative headaches. Some lawmakers question whether the new system could lead to more claims being rejected as the private companies seek to control costs and increase profits.
Louisiana Health and Hospitals Secretary Bruce Greenstein has spent months working with providers, trying to alleviate concerns and lessen opposition.
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