Federal Government Action on Louisiana Medicaid Program Overhaul Plan Not Expected During State’s Current Legislative Session

The federal government likely will not take action on a plan from Louisiana Gov. Bobby Jindal (R) to reform the state Medicaid program during the state's 2009 legislative session because of delays related to the transition in presidential administrations, Louisiana Department of Health and Hospitals Secretary Alan Levine said on Tuesday, the Baton Rouge Advocate reports (Shuler, Baton Rouge Advocate, 2/11).

Under the Louisiana Health First Plan, the state would establish Medicaid managed care pilot programs in New Orleans, Baton Rouge, Lake Charles and Shreveport. Medicaid beneficiaries in those cities would work with counselors approved by the state to select from two or more private health plans. Health insurers that operate the plans would receive a flat monthly fee per Medicaid beneficiary, with the fee based on the health of each beneficiary. In addition, health insurers would negotiate fees with physicians, hospitals and other health providers in their plan networks and collaborate to provide coordinated care (Kaiser Daily Health Policy Report, 12/19/08).

The Jindal administration had planned to promote legislation to implement the plan during the legislative session that ends June 25. However, the plan requires approval of a waiver by the federal government, a process that could take six months to complete, Levine said. Levine said, "Right now they are in a holding pattern," adding, "We are in discussions with the Legislature on how to approach it this spring," but the lack of federal approval of the waiver "makes it difficult for the Legislature to consider legislation" (Baton Rouge Advocate, 2/11).

Business Group
Blueprint Louisiana, a group that includes many business executives in the state, plans to join in Jindal's attempts to overhaul the state's health care and health insurance systems, according to a board member, the Advocate reports. Board member William Slaughter spoke about the group's agenda at the Louisiana Hospital Association's Winter Healthcare Leadership Symposium in Baton Rouge. He said, "Health care will be front and center. It will be the most critical part of what we will undertake in 2009." There is a "reasonably good fit" between the group's agenda and that put forward by Jindal, Slaughter said. He said the group's platform has six major items:

• Redirect funding for the care of the uninsured from health care centers to the individuals themselves;
  
  
• Change the focus of Louisiana State University Health Sciences Center to place more emphasis on medical education and research and less on the health care and hospital businesses. Slaughter said LSU should operate no more than four teaching "centers of excellence" instead of the 10 hospitals around the state;
  
  
• Customize care delivery models to best suit regional needs and resources;
  
  
• Expand government-funded health coverage to include about 100,000 additional low-income parents of children already enrolled in a government plan;
  
  
• Maximize federal funds for medical education; and
  
  
• Implement stricter accountability for state spending on care for the uninsured and the benefits derived from it.