HLS 17RS-3903 ORIGINAL
2017 Regular Session
HOUSE CONCURRENT RESOL UTION NO. 119
BY REPRESENTATIVE MAGEE
MEDICAID: Requests the La. Department of Health to make recommendations concerning
the prospective establishment of an independent claims review process for dental
services provided through the Medicaid managed care program
1 A CONCURRENT RESOL UTION
2To urge and request the Louisiana Department of Health to engage a select group of
3 stakeholders in the field of dental care concerning the prospective establishment of
4 an independent claims review process for dental services provided through the
5 Medicaid managed care program, and to make recommendations relative to that
6 process to the legislative committees on health and welfare.
7 WHEREAS, in an effort to achieve greater efficiency in the administration of
8Medicaid benefits, the state has contracted the administration of those benefits to private
9managed care organizations that function in substantially the same manner as private
10insurance companies, health maintenance organizations, and like entities; and
11 WHEREAS, the state clearly recognizes the need for independent, objective
12processes for resolving claims disputes between healthcare providers and private insurers
13which offer healthcare benefits, as evidenced by the legislature having enacted laws
14establishing such processes for health insurance issuers in the private sector; and
15 WHEREAS, the legislature has clearly recognized the need for an independent,
16objective process for resolving disputes over Medicaid claims by finally passing House Bill
17No. 492 of this 2017 Regular Session, referred to hereafter as "HB 492"; and
18 WHEREAS, HB 492 has been enrolled and, upon taking effect, will establish such
19an independent review process for resolving disputes over Medicaid claims between most
20classes of healthcare providers and the managed care organizations known collectively as
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HCR NO. 119
1the "Healthy Louisiana" plans; however, the bill specifically excludes from those processes
2disputes over dental care claims between dentists and Medicaid managed care organizations;
3and
4 WHEREAS, the intent of excluding dental claims from the provisions of HB 492 was
5to allow for the establishment of a separate independent review process for resolving
6disputes pertaining to Medicaid dental claims that would be better suited to the unique
7aspects of dental benefits administration.
8 THEREFORE, BE IT RESOLVED that the Legislature of Louisiana does hereby
9urge and request the Louisiana Department of Health to engage a group of stakeholders in
10the field of dental care including, without limitation, the following parties, and to collaborate
11with these stakeholders to study and make recommendations concerning the prospective
12establishment of an independent review process for claims for dental services provided
13through the Medicaid managed care program:
14 (1) Representatives of any managed care organization contracted with the state to
15administer dental benefits within the Medicaid program.
16 (2) Representatives of the Louisiana Dental Association.
17 (3) Representatives of the Louisiana Academy of Pediatric Dentistry.
18 (4) Representatives of the School of Dentistry of the Louisiana State University
19Health Sciences Center at New Orleans.
20 BE IT FURTHER RESOLVED that the Louisiana Department of Health shall
21develop a report concerning the prospective establishment of an independent review process
22for claims for dental services provided through the Medicaid managed care program, and
23shall submit the report to the House Committee on Health and Welfare and the Senate
24Committee on Health and Welfare on or before March 1, 2018.
25 BE IT FURTHER RESOLVED that a copy of this Resolution be transmitted to the
26secretary of the Louisiana Department of Health, the chief executive officer of the Louisiana
27Association of Health Plans, the executive director of the Louisiana Dental Association, the
28president of the Louisiana Academy of Pediatric Dentistry, and the chancellor of the
29Louisiana State University Health Sciences Center at New Orleans.
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HCR NO. 119
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)]
HCR 119 Original 2017 Regular Session Magee
Urges and requests the La. Dept. of Health to engage a select group of stakeholders in the
field of dental care concerning the prospective establishment of an independent claims
review process for dental services provided through the Medicaid managed care program,
and to make recommendations relative to that process to the legislative committees on health
and welfare on or before March 1, 2018.
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