Government Affairs News and Updates

Press Release Sent out by LA Department of Health and Hospitals:
(7/24/12)

DHH to Hold Forum July 31 for Stakeholder Dialogue on Planned Medicaid Dental Changes
http://new.dhh.louisiana.gov/index.cfm/newsroom/detail/2555

BATON ROUGE --- The Louisiana Department of Health and Hospitals will hold a forum at 6:30 p.m. on Tuesday, July 31, at the LSU School of Dentistry to discuss including dental services as a benefit in some Bayou Health Plans and to gather feedback on enhancing Medicaid fee-for-service dental care.

Tuesday, July 31 - New Orleans

6:30 - 8:30 p.m.
LSU School of Dentistry - Administrative Building, Auditorium C, 4th floor
1100 Florida Blvd.
New Orleans, LA 70119

Bayou Health is the State's new approach to coordinating care for most Medicaid and LaCHIP recipients. DHH has contracted with five Health Plans - Amerigroup RealSolutions, Community Health Solutions, LaCare, Louisiana Healthcare Connections and UnitedHealthcare Community Plan -- that are responsible for coordinating health care for recipients and working with them to address issues and empower them to take a more active role in owning their own health. BAYOU HEALTH was implemented for eligible Medicaid and LaCHIP recipients around Louisiana in three phases that each encompassed multiple parishes. The final implementation was June 1.

During this implementation phase, dental care was one of several services that were "carved out" of Bayou Health, meaning Medicaid recipients in health plans received dental services through the legacy Medicaid fee-for-service program. Beginning this fall, DHH plans to include dental care as a benefit for recipients in the three health plans that are a prepaid model, meaning they operate as traditional, MCO-style health care networks with a capitated rate -- Amerigroup, LaCare and Louisiana Healthcare Connections.

The other two plans, Community Health Solutions and United Healthcare Community Plan, are enhanced primary care case management networks. These plans process and pay claims through Medicaid. These two plans and legacy Medicaid account for more than half of Medicaid recipients, who will continue receiving dental services through the fee-for-service Medicaid program. Because of this, DHH is seeking feedback on how to enhance dental services and coordinate this aspect of care in the legacy Medicaid program.

At the dental forum, DHH Medicaid program leadership will give an overview of the planned transition for dental services and engage in an open dialogue with advocates and stakeholders to answer questions and address concerns.

DHH is holding the dental forum after office hours to allow more stakeholders the opportunity to attend. This forum is a public meeting, and no registration is required. Seating is limited to 300 attendees, and seats will be given on a first-come, first-served basis.

People who are unable to attend the forum can visit DHH's Bayou Health site, www.MakingMedicaidBetter.com, and view information about the upcoming changes for dental services, which is on the "Providers" section under the heading "Dental Services." This site will contain the presentation given at the dental forum, along with questions and answers.

DHH will update the website frequently during this process. The public is advised to check here often to see the latest details. Visitors to the site also can review information about Bayou Health, subscribe to DHH's newsletter for frequent email updates and submit questions or comments electronically. Stakeholders can also email their comments or questions to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 

Update on FMAP and Dental Medicaid: Dental Medicaid NOT Cut by FMAP Budget Shortfall, Dental Added to Bayou Health CCNs (7/17/12)

As many of you may have read via an LDA alert a couple weeks ago and/or in your local newspapers, the LA Department of Health and Hospitals (DHH) was forced to address the budget shortfall resulting from Congress's action that resulted in a decrease to the state's disaster-recovery Federal Medical Assistance Percentage (FMAP) rate from 71.92% to a projected 65.51% - according to DHH, the rate represents the lowest reimbursement rate Louisiana has had in more than 25 years.

In positive news, DHH announced their budget reduction plan, and in the current plan, Dental Medicaid has NOT been cut above the 3.7% necessitated in the state's budget (HB 1, implemented July 1). Even though this is not a small amount, it is far smaller than what we had been warned to be prepared for in this last budget shortfall caused by the FMAP rate. For the budget reductions release sent out by DHH on Friday, July 13, visit http://new.dhh.louisiana.gov/index.cfm/newsroom/detail/2550.

Even though Dental Medicaid was spared an additional round of debilitating cuts that would have certainly gutted the program, cuts to Medicaid and many DHH programs are steep. For additional information on cuts, read the following articles:
Times Picayune: http://www.nola.com/politics/index.ssf/2012/07/louisiana_cuts_medicaid_progra.html
The Advocate:
http://theadvocate.com/home/3338762-125/jindal-cuts-lsu-hospitals-to

However, in related news, in an effort to meet their budget goals, DHH has projected that they will achieve additional savings by carving dental and pharmacy services into their managed care system (Coordinated Care Networks, CCNS) called BAYOU HEALTH. DHH's preliminary date for implementation is October 1, 2012. LDA is weighing the options of seeking to delay or derail carving dental into CCNs. However, since some of the anticipated savings that kept dental providers from having their reimbursement rates cut in the FMAP budget shortfall are closely tied to the CCNs, pursuing either option is likely to be very difficult.

For example, DHH will eliminate the contract that provided prior-authorization services for the Medicaid dental benefits. The contract is no longer needed since DHH plans to carve dental services into BAYOU HEALTH, where the health plans will become responsible for all aspects of administering dental benefits, including prior authorization, for Medicaid members in their networks. This will have an impact on the LSU School of Dentistry, which currently services the prior authorization contract for DHH.

Medicaid Task Force Chair Dr. Don Donaldson has been in contact with DHH almost daily and Dr. Donaldson and LDA Executive Director Ward Blackwell have participated in numerous meetings and conference calls sorting through the details of the upcoming changes to the program. DHH has expressed a willingness to schedule a few Forums in as many as three locations in different parts of the state regarding carving dental into BAYOU HEALTH. More information on this issue, as well as any definite dates and Forum details, will be disseminated as soon as it becomes available.

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