The Louisiana Department of Public Health introduced companies to obtain Medicaid managed care contracts for 2020. New offered contracts include Community Care Health Plan of Louisiana and Humana Health Benefit Plan of Louisiana, while AmeriHealth Caritas Louisiana and United Healthcare Community Plan had their contracts renewed.
Two modern-day Medicaid managed care contractors, Centene’s Louisiana Healthcare Connections and Aetna Better Health, did now not receive new contracts.
Louisiana Healthcare Connections stated it might record a formal protest, in line with a document.
Dive Insight:
Louisiana has made some sizeable adjustments to its Medicaid application in the latest years. It expanded Medicaid eligibility in early 2016 below the Affordable Care Act after Gov. John Bel Edwards, a Democrat, the earlier November. His predecessor, Republican Bobby Jindal, had moved Louisiana’s Medicaid enrollees into managed care.
And now, the Louisiana Department of Public Health has shaken up the method even greater, losing carriers that manipulate blessings for roughly a third of the country’s 1.7 million Medicaid enrollees. The branch did not give any unique reasons at the back of the selection, which was announced Aug. Five.
The biggest loser is Louisiana Healthcare Connections, which controlled more than 440,000 lives; Aetna controlled slightly greater than one hundred fifteen,000. Louisiana Healthcare Connections acquired the lowest score of all of the bidders. A spokesperson for Louisiana Health Connections did no longer respond to a request seeking comment.
Randal Johnson, a lobbyist for Louisiana Health Connections, instructed the Associated Press that the employer might be in a formal protest in opposition to the decision, which would be due by Aug. 19.
“I’m quite positive based on the whole lot I’ve been told that that manner performed out the way that it must have,” Bel Edwards stated. “If they have some purpose to trust that there was a flaw in the system, they genuinely have the potential to convey that to the eye of the right authorities.”
Although the maximum of the cases mentioned situation the medical doctor-patient dating, as discussed previously, the identical standards practice to all fitness care vendors. Furthermore, due to the fact the care rendered through the house fitness company is supplied under a health practitioner’s plan of care, even supposing the affected person sued the health practitioner for abandonment due to the movements (or inactions of the home fitness agency’s body of workers), the physician may also are seeking indemnification from the house fitness issuer. [6]
ABANDONMENT BY THE NURSE OR HOME HEALTH AGENCY
Similar ideas to those who follow to physicians observe to the house health professional and the home health issuer. A home health organization, because the direct provider of care to the homebound patient, can be held to the equal prison duty and responsibility to supply care that addresses the patient’s desires, as is the medical doctor. Furthermore, there can be both a felony and a moral duty to continue delivering care if the affected person has no alternatives. An ethical duty may exist to the affected person even though the house health company has fulfilled all felony duties. [7]
When a domestic fitness provider furnishes the remedy to an affected person, the duty to keep imparting care to the affected person is an obligation owed by using the enterprise itself and not by way of the man or woman professional who may be the worker or the contractor of the employer. The domestic fitness provider does now not have an obligation to keep imparting the identical nurse, therapist, or aide to the affected person all through the path of treatment, so long as the company continues to apply appropriate, in position employees to administer the path of treatment continually with the plan of care.
From the perspective of affected person satisfaction and continuity of care, it may be inside the home health company’s quality hobbies to attempt to offer the same character practitioner to the affected person. The improvement of a non-public courting with the company’s personnel might also enhance communications and a more degree of acceptance as true with and compliance on the affected person. It must help alleviate a few of the issues that get up within the fitness care’ setting.
