Health plan law changes sought

• By MARSHA SHULER
• Advocate Capitol News Bureau
• Published: Nov 25, 2008 - Page: 1A - UPDATED: 12:05 a.m.

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State health chief Alan Levine wants the Legislature to rewrite the law that provides the framework for the restructuring of Louisiana’s health-care system for the poor and uninsured.

Levine said he needs more specific guidance on what lawmakers want to see implemented.

But the legislative sponsor of the law does not understand Levine’s problem.

“How can you argue something is too broad in allowing you to do what you want to do? It was intentionally meant to be broad where you don’t preclude moving health care along in the state of Louisiana,” said state Sen. Joe McPherson, D-Woodworth.

The 2007 Legislature approved the law based on work done during Gov. Kathleen Blanco’s administration. At the heart of the plan is establishment of “medical networks of care.”

Under the plan, the state would oversee managed-care networks that public and private health-care providers would put together. Primary-care physicians and clinics would provide “medical homes” and act as gatekeepers, referring patients to specialists and hospitals, as needed.

Gov. Bobby Jindal’s administration is pushing “coordinated care networks” based on insurance-based managed-care organizations. The administration wants to move away from the current Medicaid “fee for service” to the paying of a fixed premium per patient signed up with private managed-care plans.

Medicaid is the government’s $7 billion-plus health insurance program for Louisiana’s poor and uninsured.

In an interview, Levine said the 2007 law describes what is wanted in too broad of terms.

“It’s not enough for the Legislature to say provide for a medical home model, accountability for (health-care) providers, managed-care reimbursement principals. That gives us an awful lot of latitude,” Levine. said

“I would be uncomfortable making these broad policy decisions without authority to do it,” Levine said.

House Speaker Jim Tucker, R-Terrytown, said he has heard Levine talk about altering the law.

“He really wants to make sure he has the authority, direction from the Legislature,” Tucker said.