Requests the Department of Health and Hospitals to facilitate the processing and payment of Medicaid claims.
Impact
The passage of SCR157 would prompt the DHH to develop a comprehensive plan by August 1, 2014, intended to rectify existing issues with claims processing and to clarify the future payment procedures for claims made to the Bayou Health program and the Louisiana Behavioral Health Partnership. This could significantly improve the financial stability of healthcare providers who rely on timely reimbursements for their services, ensuring they have the resources necessary to continue providing care.
Summary
SCR157 is a Senate Concurrent Resolution that urges the Louisiana Department of Health and Hospitals (DHH) to facilitate the timely processing and payment of Medicaid claims. The resolution highlights the challenges faced by healthcare providers under the Bayou Health program and the Louisiana Behavioral Health Partnership, where providers have reported issues with claims being denied or delayed due to unclear responsibilities among contractors. This resolution aims to address these ongoing payment problems to enhance provider capabilities and ensure continued access to care for all residents of Louisiana.
Sentiment
The sentiment surrounding SCR157 appears to be supportive among legislators who acknowledge the critical role that timely Medicaid claim processing plays in the healthcare system. Proponents see the resolution as a necessary action to alleviate financial strains on providers, which, in turn, benefits patients. However, there is also a recognition of the complexities and systemic issues within the Medicaid claims process, suggesting a nuanced approach is needed to resolve these challenges effectively.
Contention
While SCR157 has garnered support aimed at improving healthcare delivery, it opens discussions about accountability among the contractors responsible for Medicaid management. Some stakeholders might express concerns over whether simply urging the DHH is sufficient, or if more substantial reforms are required to address the underlying problems within the Medicaid system. The resolution's efficacy will depend on the implementation of the recommended plans and whether they lead to real improvement in claims processing and payments for healthcare providers.
Urges and requests the Department of Health and Hospitals to study Medicaid reimbursement and recoupment processes with respect to payments to nonemergency medical transportation providers
Requests the Department of Health and Hospitals to develop a plan for the creation of a demonstration program to coordinate and integrate the health care for an individual eligible for both Medicare and Medicaid.
Requests that the Department of Health and Hospitals continue its reliance on the Medicaid Purchase Plan Advisory Council for program outreach, education, review, and guidance.
Requests DHH to develop a plan for the creation of a demonstration program to coordinate and integrate the health care for an individual eligible for both Medicare and Medicaid.
Requests the Department of Health and Hospitals to submit a report to the Legislature of Louisiana that addresses how the department and its contractors combat Medicaid fraud and abuse.
Requests the Department of Health and Hospitals to seek a Medicaid state plan amendment from the Centers for Medicare and Medicaid Services to include as a Medicaid service the Tdap vaccine to pregnant women and to provide a cost analysis to the legislature for providing this Medicaid service.
Requests the Department of Health and Hospitals to study possible methods which would increase the provision of graduate medical education in central Louisiana by designating certain hospitals which enter into public/private partnerships with Huey P. Long Medical Center as major teaching hospitals for purposes of Medicaid reimbursement.
Requests the Department of Health and Hospitals to promote the department's EarlySteps system with the Louisiana Hospital Association, the Louisiana State Medical Society, and the Optometry Association of Louisiana.