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