Louisiana House Bill HB566

Louisiana 2016 Regular Session

• Introduced: 3/3/16
• Refer: 3/3/16
• Refer: 3/14/16

Caption

Requires the Department of Health and Hospitals to institute certain Medicaid cost containment measures (OR -$34,298,198 GF EX See Note)

Impact

The legislation is anticipated to recalibrate how Medicaid services are accessed and utilized, specifically reducing unnecessary emergency room visits for conditions deemed nonemergent. By limiting reimbursement in these cases, it aims to control the growth of Medicaid expenditures, which, according to legislative findings, have become unsustainable. This could lead to a shift in healthcare provisions towards more traditional outpatient facilities for nonemergent conditions, ideally promoting more suitable healthcare choices among beneficiaries.

Summary

House Bill 566 intends to implement Medicaid cost containment measures in Louisiana by establishing rules governing cost sharing and restricting coverage for nonemergency services provided in hospital emergency rooms. The bill mandates that the state's Department of Health and Hospitals (DHH) develop policies that adhere to federal regulations regarding cost sharing, which would require certain Medicaid enrollees to contribute to the costs of services they use. By targeting nonemergency visits to emergency rooms, which constitute a significant expense for Medicaid, the bill aims to reduce expenditures associated with the program while maintaining compliance with federal guidelines.

Sentiment

The overall sentiment around HB 566 appears to be a mix of fiscal responsibility and potential access issues for Medicaid recipients. Proponents argue that the bill is a necessary step to safeguard the financial viability of the Medicaid program by discouraging inappropriate usage of emergency services. Conversely, critics raise concerns that limiting coverage could prevent patients from accessing timely medical care in emergency situations, thereby undermining health outcomes for vulnerable populations who may rely on emergency services.

Contention

Notable points of contention include debates regarding the extent to which cost-sharing might deter necessary healthcare access for low-income individuals who might already be facing significant barriers to care. The requirement that enrollees have utilized emergency services for nonemergent issues multiple times before incurring additional costs is intended to target the misuse of emergency rooms; however, this could disproportionately affect those who have chronic conditions or lack access to primary care, prompting worries about imposing financial hurdles to access basic health services.