HLS 16RS-4128 ORIGINAL
2016 Regular Session
HOUSE RESOLUTION NO. 162
BY REPRESENTATIVES HENRY AND MONTOUCET
MEDICAID: Requests the Dept. of Health and Hospitals to determine whether the
Medicaid managed care program has achieved cost savings
1 A RESOLUTION
2To urge and request the Department of Health and Hospitals to conduct a study to determine
3 whether the Medicaid managed care program of this state has achieved cost savings
4 when compared with the fee-for-service Medicaid program which preceded it, and
5 to provide a report of the cost comparison to the legislature.
6 WHEREAS, in 2011, the Department of Health and Hospitals, referred to hereafter
7as the "department", instituted managed care within the state's Medicaid program through
8adoption of administrative rules which are now codified in Subpart 3 of Part I of Title 50 of
9the Louisiana Administrative Code (LAC 50:I.2101 et seq.); and
10 WHEREAS, these administrative rules establish a risk-bearing managed care
11organization model which began operating in 2012 and was known as "Bayou Health" until
12being renamed "Healthy Louisiana" in May of 2016; and
13 WHEREAS, since its inception, the Medicaid managed care program has grown to
14encompass over ninety percent of the state's Medicaid population and currently excludes
15only Medicaid enrollees receiving long-term care services in institutional or home-based
16settings who have remained in the managed care program's predecessor, the fee-for-service
17Medicaid program sometimes referred to as "legacy Medicaid"; and
18 WHEREAS, according to the department, the purposes of instituting Medicaid
19managed care include simplifying the budgeting process for Medicaid generally and
20generating cost savings for the state; and
Page 1 of 3 HLS 16RS-4128 ORIGINAL
HR NO. 162
1 WHEREAS, as confirmed by former officials of the department in testimony before
2committees of the legislature, the department did not develop baseline cost estimates for a
3continuation of Medicaid as a fee-for-service program exclusively beyond the time that
4managed care was instituted which could be compared to the costs of the managed care
5program, and actual data from a comparable population is not available; and
6 WHEREAS, cost savings figures associated with Medicaid managed care that the
7department previously presented to the legislature were savings estimates and were neither
8comprehensive nor fully verifiable.
9 THEREFORE, BE IT RESOLVED that the House of Representatives of the
10Legislature of Louisiana does hereby urge and request the Department of Health and
11Hospitals to conduct a study to determine whether the Medicaid managed care program of
12this state has achieved cost savings when compared with the fee-for-service Medicaid
13program which preceded it.
14 BE IT FURTHER RESOLVED that the department shall develop a written report
15which addresses findings of the study, and that the report shall conform to the following
16specifications:
17 (1) Be comprehensive and supported by verifiable data, facts, calculations, and
18appropriate assumptions.
19 (2) Include costs of delivery of covered services through the Medicaid managed care
20program compared with the costs associated with service delivery through the fee-for-service
21Medicaid program.
22 (3) Include all administrative costs of operating the Medicaid managed care program
23including payments to the Medicaid fiscal intermediary, payments for consulting contracts
24for services used in operating the managed care program, and costs of payroll and related
25benefits.
26 (4) Be conducted by providers of actuarial services or accounting and auditing
27services who are independent of the department, the operation of the Louisiana Medicaid
28program, and the managed care organizations which currently contract with the department
29to operate the Medicaid managed care program.
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HR NO. 162
1 BE IT FURTHER RESOLVED that the department shall submit the report required
2by this Resolution to the House Committee on Appropriations and the House Committee on
3Health and Welfare no later than sixty days prior to the convening of the 2017 Regular
4Session of the Legislature of Louisiana.
5 BE IT FURTHER RESOLVED that a copy of this Resolution be transmitted to the
6secretary of the Department of Health and Hospitals.
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HR 162 Original 2016 Regular Session Henry
Requests the Department of Health and Hospitals to conduct a study to determine whether
the Medicaid managed care program of this state has achieved cost savings when compared
with the fee-for-service Medicaid program which preceded it, and to report findings to the
House Committee on Appropriations and the House Committee on Health and Welfare.
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