Legislative Affairs: Louisiana Health Care Commission Meeting on Louisiana Medical News

Legislative Affairs: Louisiana Health Care Commission Meeting

By: CINDY BISHOP

The Louisiana Health Care Commission met Friday January 29, 2010, in Baton Rouge.

The commission meets under the auspices of the Louisiana Department of Insurance. Created under former Commissioner Jim Brown, the commission makes recommendations to the Department of Insurance relative to public policy issues.

Donna Fraiche chaired the meeting. She announced three new commission members. Ron Nezat has been named to the Commission as a representative of the Louisiana Association of Health Underwriters. Dr. Hugh McKnight has been named to the Commission as a representative of the National Dental Association. Derrell Cohoon has been named to the Commission representing America’s Health Insurance Plan.

Ms. Fraiche announced that in late January, Governor Bobby Jindal had a press conference to announce a collaboration between Our Lady of the Lake Medical Center and Earl K. Long. The plan is to move graduate medical education to OLOL and the services to the patients from EKL to OLOL to provide additional resource and services. Note, however, that this collaboration is subject to approval by the LSU Board of Supervisors and the Louisiana Legislature.

Julia Kenney, chief of staff, Louisiana Department of Health and Hospitals, reported on public policy issues facing their Department. Our state is facing a “cliff” on December 31, 2010 where our FMAP rate drops 18 percentage points. This will create a $900 million void, annualized. Under this scenario, the Louisiana match rate for Medicaid would be 63 percent. Coupled with this impending doom, DHH just cut $154 million from their budget to address the mid-year budget deficit. She reported that DHH is working with the Louisiana Workforce Commission on a transition plan for the DHH employees who lost their jobs as a result of mid-year budget cuts.

She spoke briefly about the 1115 Medicaid Waiver pending before the Center for Medicare and Medicaid (CMS). DHH has applied to expand Medicaid coverage and they anticipate a $15 million cost savings if the waiver is approved. The waiver deals with coordinated care networks and allows for Medicaid payments to be made on either a fee-for-service basis or be pre-paid (managed care).

Karen Winfrey, director of the Office of Health Insurance, discussed the Departments’ 2010 legislative package. The Louisiana Department of Insurance plans to sponsor legislation during the 2010 legislative session to:

Address the “loophole” on balanced billing
Address network adequacy for managed care organizations
Clarify the “Baby Bill” to work with the Louisiana Department of Health and Hospitals and with hospitals to use Medicaid dollars to purchase Medicaid (Winfrey referred to this as the “Who-What-Where” bill)
To extend coverage up to age 24 for persons who are not enrolled in school but who are dependents of their parents.
To enact “Michelle’s law,” a federal mandate
To ensure that an employee knows that their insurance policies have been terminated
To allow for coverage of out of state providers such as MD Anderson, if the facility agrees to accept the insurance payment.
To give the Commissioner of Insurance the authority to promulgate administrative rules and regulations in the event that Congress moves to enact federal healthcare reform.

When asked to clarify the legislation on closing the loophole on balanced billing, Winfrey stated that there is a practice which allows a non-contracted provider for an insured to send a bill to the patient for the “balance” left on their bill. “The Commissioner believes that is not fair and I agree with him,” Winfrey said. She gave the example of a person going to an in-network facility for gallbladder surgery. She said that whereas the surgery is done in an in-network facility, however, “out of network doctors treat you and send you a bill.”

The Insurance Department is hosting a Health Care Symposium Tuesday, March 23, at the Crowne Plaza in Baton Rouge.

Winfrey stated that the Insurance Department plans to have their draft legislation for the Louisiana Health Care Commission to preview at their March 2010 meeting.

Legislative Affairs content is provided by Checkmate Strategies, publisher of Health Care Information Services. All content © Checkmate Strategies and Louisiana Medical News, LLC. For more information, readers may contact Cindy Bishop at 225.923.1599 or P.O. Box 80053, BR, LA 70598, or send email to destiny362@aol.com. The Web site is www.checkmate-strategies.com

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