Too much bureaucracy in the Jindal administration’s private sector-based Medicaid managed care program is threatening patient access, a Louisiana State Medical Society official said Wednesday.
Greg Waddell, the society’s director of legal affairs, told a state House committee that efforts to correct problems through the state health agency and private plans have gotten nowhere so legislation is needed.
A House panel agreed, approving House Bill 392 aimed at fixing administrative problems physicians and other providers are encountering with Bayou Health. HB392 would make technical rules changes that would speed processes.
“It helps this program become much better,” Waddell said.
HB392, sponsored by state Rep. Stuart Bishop, R-Lafayette, now goes to the House floor for debate.
The Bayou Health program provides health care for about two-thirds of the state’s more than 1 million Medicaid recipients, mainly children. Participants opt for one of five health plans for care delivery with the state either paying an insurance premium or reimbursing on a fee-for-service basis.
Late Wednesday, interim state health chief Kathy Kliebert issued a statement that said in part, “We will continue to work with the author and other stakeholders to address and resolve their concerns, as we have done since Bayou Health began.”
Kliebert said her agency is concerned about “both the fiscal and programmatic impact HB392 will have on the Bayou Health program should it become law.”
In committee, two of the participating health plans — AmeriGroup and United Health — the Louisiana Association of Health Plans and the Governor’s Office registered their opposition. Representatives of none of them opted to testify.
Waddell said a lot of physicians have become very frustrated with the amount of administrative overhead that they have to go through. He said it is taking six to nine months before physicians can get credentials and get their claims paid.
Legislators said they have been hearing a lot from physicians in their communities.
“I am being told by many local physicians — this in a high Medicaid area — a lot are no longer accepting new patients. Some are thinking about dropping some of the patients they already have,” said state Rep. Bernard LeBas, D-Ville Platte.
LeBas said pharmacists are also running into problems.
“There’s absolutely a problem,” agreed state Rep. J. Rogers Pope, R-Denham Springs. “Maybe legislation was necessary in order to get something accomplished.”
Waddell said Bayou Health contracts are between the state Department of Health and Hospitals and the five health plans.
“The opportunity to change the rules is there,” Waddell said. He said an administrative simplification committee exists but there’s been no movement toward fixing the problems.
“This administrative bureaucracy is a large stumbling block to participation,” said Dr. Keith De Sonier, a Lake Charles ear, nose and throat physician.
The measure had the support of the Louisiana Hospital Association, Medicine Louisiana, the American Academy of Pediatrics Louisiana Chapter, the Louisiana Consumer Health Coalition and the Advocacy Center.