BATON ROUGE, La. (WVLA / WGMB) — The insurance group that covers more Medicaid enrollees than any other in Louisiana plans to protest the state’s latest contractual decision.
Louisiana Healthcare Connections is preparing an appeal with the state procurement office, after the Louisiana Department of Health announced it would not renew its contract with the managed-care organization. The newly proposed award arrangement could leave some 440,000 of the company’s Medicaid recipients — and 560,000 patients overall — seeking new health plans.
“Not getting a contract was a total shock,” Louisiana Healthcare Connections spokesman Chris Broussard told BRProud.com in an interview Wednesday. “When you have a history of high member satisfaction, you typically get the impression that you’re doing a good job.”
The current contracts — with Louisiana Healthcare Connections, Aetna, AmeriHealth Caritas, Healthy Blue and United Healthcare — were filed under former Gov. Bobby Jindal’s administration and expire Dec. 31. The five managed-care organizations received $7.6 billion in payments during the 2018 fiscal year, covering more than 1.7 million Medicaid enrollees.
Gov. John Bel Edwards’ administration awarded multi-billion-dollar Medicaid contracts earlier this month to four companies: AmeriHealth Caritas, Healthy Blue, Humana and United Healthcare. The Louisiana Department of Health rejected bids from Aetna and Louisiana Healthcare Connections.
Lawmakers at Louisiana’s State Capitol and on Capitol Hill have spoken against the prospect of displacing thousands of Medicaid enrollees.
“Who is their doctor? Who do they go see?” state Sen. Sharon Hewitt (R-Slidell) said at a legislative budget meeting Tuesday. “It seems like the whole system is being turned upside down.”
“It is unlikely that a new [managed care organization] will be able to duplicate LHCC’s provider network, resulting in many of these constituents losing their current providers,” U.S. Rep. Cedric Richmond (D-New Orleans) wrote in a letter to the governor Friday.
State administrators argue that the new contracts will provide health care at lower costs, adding that most Medicaid providers work with multiple insurers.
“There’s not going to be an issue where we have no doctors,” health secretary Dr. Rebekah Gee told legislators Tuesday.
Edwards spokeswoman Christina Stephens maintains that medical practitioners will have a chance to join the new plans.
“The procurement process for selecting new Medicaid managed care organizations was not about any individual company or particular plan,” Stephens said in a statement. “This is good news for Medicaid participants, who will be able to choose a plan that works for them when open enrollment happens later this year.”
The open enrollment period starts Oct. 15 and runs through Nov. 30.
For the unsuccessful bidders, the loss of awards could also jeopardize jobs. Louisiana Healthcare Connections has roughly 675 employees statewide.
“We know there will likely be job opportunities with the successful bidders, including one that is new to the program,” Stephens said. “To that end, we will work through the Louisiana Workforce Commission to schedule hiring events and job fairs to connect these employees to opportunities with the successful bidders and other companies in the state, as we would with any employer facing a layoff.”
The Louisiana Department of Health plans to execute its new contracts by Aug. 23. The agency is still negotiating the terms of its deals with the four winning bidders.
Louisiana Healthcare Connections has until Aug. 19 to submit its protest to the state procurement office.