Although the topic was not on the agenda, Louisiana legislators spent much of Tuesday’s monthly budget meeting grilling Department of Health officials about Medicaid oversight.
The department has suspended a feature of its Medicaid eligibility system that would have automatically kicked out 75,000 people for failing to respond to requests for annual renewal information during July and August. Officials said they want to ensure no one would be kicked off the program through no fault of their own while staff worked through a backlog of responses.
Secretary Rebekah Gee said it was part of the “learning curve” for the new system. State Rep. Lance Harris, an Alexandria Republican, said many of the people who didn't respond may have moved out of state, yet the program was still paying for their coverage.
“It bothers me as a taxpayer,” Harris said, suggesting the upcoming election might have had something to do with the decision.
Lawmakers also raised concerns about the selection of four managed care organizations for the Medicaid program. MCOs are similar to health insurance providers and are paid a flat fee by the state for each person who enrolls.
Two current MCOs were not among those selected for the contracts, including Louisiana Healthcare Connections, which serves about a quarter of the state’s Medicaid population and plans to protest the decision.
Legislators said they had a good relationship with the existing providers and questioned why MCOs that don’t currently have a network of health care providers were scored higher than some that do. Health department officials said it would be unrealistic to expect a company that doesn’t have a Medicaid contract yet to already have providers in place, stressed that none of the applicants objected to the published criteria and noted that no political appointees were involved in the rankings.
Officials plan to begin open enrollment by Oct. 15, with the new contracts going into effect Jan. 1, although they said the pending protest could alter the timeline. While many Medicaid recipients will be forced to choose a new plan, they said plans are in place to help them keep their doctors.
“Nobody in Louisiana is guaranteed a permanent contract,” Gee said of the current MCOs.
State Rep. Tony Bacala, R-Prairieville, called for the Legislative Auditor to review whether the correct process was followed when the new MCOs were selected.
He also raised questions about the process for awarding a Medicaid dental coverage contract, in which one company’s bid package was opened early even though all bids for a contract were supposed to be opened at the same time. Department officials confirmed a bid was unsealed when it should not have been, but said no attempt to sway the process in favor of any bidder was uncovered.
“The credibility of that bidding process is in great question,” Bacala said. “I don’t know if there’s any way now to make it not smell horrible.”