The Louisiana Department of Health announced its intent to contract with four Medicaid managed care organizations following a state bid process that began in February when the Department issued a request for proposals.
The Department has selected AmeriHealth Caritas Louisiana, Community Care Health Plan of Louisiana (Healthy Blue), Humana Health Benefit Plan of Louisiana, and United Healthcare Community Plan as its managed care partners (or health plans) beginning in January 2020.
The selected managed care organizations will be responsible for providing Medicaid benefits and services to eligible children and adults in Louisiana.
Most Medicaid enrollees receive their healthcare through the managed care delivery model, with the exception of long-term supports and services. The participating managed care organizations are paid on a per-member-per-month (PMPM) basis. Under this arrangement, Medicaid pays managed care organizations a monthly fee to manage the health needs of their members.
Medicaid made $7.6 billion in payments to the five managed care organizations during the 2018 fiscal year. These payments covered more than 1.7 million Medicaid enrollees.
The current contracts with United Healthcare Community Plan, AmeriHealth Caritas, Louisiana Healthcare Connections, Aetna, and Healthy Blue expire December 31, 2019.
Medicaid enrollment information
The award of these new contracts will not affect the Medicaid eligibility of any member. However, members may need to choose a new health plan if their current health plan is not awarded a new Medicaid contract.
Members will have the opportunity to select a new health plan through the open enrollment process beginning in October. Medicaid will provide assistance and information to members through the Medicaid website, from Medicaid providers, and mail alerts.
The contracting process
The Department of Health has notified all bidders and will begin contract negations. The next step is a protest period. The current implementation timeline is shown, below. However, it could change in the event of a protest.
-Contract execution, on or about Aug. 23, 2019
-Open enrollment: Oct. 1 – Nov. 14, 2019
-Operational start date, on or about Jan. 1, 2020