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Louisiana congressman questions Medicaid contract awards

by Associated Press

BATON ROUGE, La. (AP) — Gov. John Bel Edwards is facing questions about his administration’s multibillion-dollar Medicaid contracting decisions from a fellow Democrat, U.S. Rep. Cedric Richmond.

Richmond sent a letter to the governor Friday, raising concerns that the administration’s new Medicaid managed care contract awards leave out the largest current contractor in the program, Louisiana Healthcare Connections, known as LHCC.

The congressman, who represents a New Orleans-based district that stretches into Baton Rouge, said he worries about hundreds of job losses in his district and disruption in care for thousands of Medicaid patients who will have to move to new health plans.

“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,” Richmond wrote.

He also said Louisiana’s health department has had technology problems that would likely make it difficult to shift patients to new health plans without “at least some of these patients falling through the cracks for a time.”

Louisiana contracts with managed care companies to oversee the government-financed health coverage provided to 1.7 million Medicaid enrollees, about 90% of the people in the program.

The contracts are similar to the arrangements made in private insurance. The state pays a monthly fee for each person enrolled in a health plan with the companies — mostly adults covered by Medicaid expansion, pregnant women and children. The enrollees get services through a network of primary care doctors, specialists and hospitals.

Current managed care contracts with five companies, negotiated by former Gov. Bobby Jindal’s administration, expire this year. The Edwards administration selected four companies to do the lucrative work starting in January. Terms of the deals remain to be settled.

Louisiana Healthcare Connections — which provides coverage for about 26% of current Medicaid managed care patients, or 440,000 people — was one of two companies that weren’t selected for the next round of contracts. The company said it has about 675 employees in the state.

The announcement has drawn criticism and questions from lawmakers similar to those lodged in Richmond’s letter. Louisiana Healthcare Connections said it intends to dispute the contract decisions through a formal protest to the state procurement office.

Edwards spokeswoman Christina Stephens defended the managed care contract awards, saying the decisions were made in an effort to provide better health care and lower program costs.

“While there may be some change in the companies involved, we know the vast majority of Medicaid providers in the state participate in multiple (managed care) plans and will have the opportunity to join the new plan,” Stephens said in a statement.

She said Edwards expects that employees of the companies whose contracts are ending could have “job opportunities with the successful bidders” and the labor department will schedule job fairs to help anyone losing employment.

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