Requests the Department of Health and Hospitals to facilitate the processing and payment of Medicaid claims.
Impact
If implemented, SCR166 would have significant implications for state Medicaid operations. The resolution calls for DHH to establish clear protocols for processing and compensating claims under the Bayou Health program. This is critical as healthcare providers have faced challenges in receiving payments, directly affecting their ability to deliver necessary care. The anticipated improvement in claims processing could enhance the financial viability of healthcare institutions and ensure continued access to services for Louisiana residents, highlighting a commitment to healthcare efficacy in the state.
Summary
SCR166 is a Senate Concurrent Resolution aimed at urging the Louisiana Department of Health and Hospitals (DHH) to expedite the processing and payment of Medicaid claims. The resolution acknowledges the complexities and ongoing issues within the Bayou Health program and the Louisiana Behavioral Health Partnership, particularly concerning the management of Medicaid claims by various contractors. It highlights the negative impact that delays and payment denials have on healthcare providers and the potential repercussions for patient care across the state. By requesting effective strategies from DHH, the resolution seeks to alleviate the financial pressures faced by providers due to ineffective claims processing.
Sentiment
The sentiment surrounding SCR166 appears predominantly supportive, particularly from healthcare providers who are eager for a resolution to the ongoing issues with claims payment. The resolution garnered a unanimous vote in the Senate, reflecting broad legislative agreement on the need to address inefficiencies in the Medicaid claims process. However, this support may be coupled with skepticism regarding the DHH's ability to execute the proposed changes effectively, indicating a complex interaction of hope and cautious optimism within the healthcare community.
Contention
Despite the resolution's positive reception, some potential contention lies in the implementation phase. Stakeholders may raise concerns regarding the effectiveness of DHH’s plan to resolve existing payment issues, especially if solutions require significant changes to operating procedures or dedicated funding. Achieving a balance between expediting claims and ensuring thorough oversight remains a critical point of discussion, as the resolution strives to maintain the integrity and quality of healthcare services while improving financial processes.
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 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 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 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 and the Louisiana Ambulance Alliance to work in collaboration through the Emergency Medical Services Professional Working Group to meet certain goals and to report to the Senate and House committees on health and welfare by February 1, 2012.