Kaisernetwork.org – Dec. 19, 2008.

The Louisiana Joint Health and Welfare Committee on Thursday unanimously approved a plan that would allow the administration of Gov. Bobby Jindal (R) to apply for a federal waiver to overhaul the state’s Medicaid program, the New Orleans Times-Picayune reports (Moller, New Orleans Times-Picayune, 12/19). Under the “Louisiana Health First Plan,” managed care pilot programs would be established in New Orleans, Baton Rouge, Lake Charles and Shreveport. Medicaid beneficiaries would work with state-approved counselors to choose between two or more private health plans.  Click title to read more…

Insurers would be paid a flat monthly fee per beneficiary, which would vary depending on the beneficiary’s health. Plans then would negotiate fees with doctors, hospitals and other providers in the network and collaborate to provide coordinated care. Eventually the plan would expand coverage to 106,000 uninsured state residents. The plan would be funded by asking the federal government to excuse debt owed by the state for past overspending and by redirecting money that now goes to LSU Charity Hospital System for treating uninsured patients. The plan also would generate savings through better coordinated care (Kaiser Daily Health Policy Report, 12/3).

Although committee members approved the plan, they “made it clear that they are far from sold on [its] details … and want to preserve the option of adopting a different health care model than the one Jindal is advocating,” the Times-Picayune reports. State Department of Health and Hospitals Secretary Alan Levine said that lawmakers will retain the option of not implementing the proposal, even if the federal waiver is granted.

On Friday, the Joint Legislative Committee on the Budget will vote on whether to apply for the waiver. If approved, the waiver application will be submitted to CMS. According to the Times-Picayune, CMS typically takes six months or more to decide on Medicaid waivers; however, it could take longer because of the administration change over. In addition, even if CMS grants the waiver, the plan still will require “several rounds of approval” before its implementation, according to the Times-Picayune. In the interim, the Jindal administration plans to propose some provisions of the initiative to the Legislature this spring. State Senate Health and Welfare Committee Chair Willie Mount (D) said she does not think the Legislature will approve any major health care legislation until the federal government has made its decision on the waiver (New Orleans Times-Picayune, 12/19).