Protests Could Stall Louisiana Medicaid Contract Negotiation

Louisiana Health Secretary Rebekah Gee answers questions from the joint House and Senate budget committee about new contract awards for the Medicaid managed care program, on Tuesday, Aug. 13, 2019, in Baton Rouge, La. (AP Photo/Melinda Deslatte)

BATON ROUGE, La. (AP) — Despite an ongoing challenge to the contract awards, Louisiana’s health department wants to continue negotiating terms with four companies chosen to manage Medicaid patient care, saying delays could put health services at risk.

Health Secretary Rebekah Gee filed the request Monday with Louisiana’s chief procurement officer Paula Tregre, who is reviewing the contract awards to determine if state law was properly followed.

Contract negotiations automatically stalled when two losing bidders for the multibillion-dollar deals formally protested the awards . But Gee is asking to allow her agency to restart its work to move to the new contracts by January.

“This delay has the potential to disrupt and jeopardize the provision of health care to more than 1 million of Louisiana’s most vulnerable citizens,” Gee wrote.

The two companies challenging the contract awards, Louisiana Healthcare Connections and Aetna Better Health, say Gee’s claims are at odds with her testimony before a legislative committee. Gee told lawmakers last week that Medicaid patient care wouldn’t be interrupted.

At issue are contracts for private companies to oversee care for about 90-percent of Louisiana’s Medicaid enrollees, an estimated 1.5 million people. The contracts are among the largest in state government, accounting for roughly one-quarter of the state’s annual operating budget.

Gov. John Bel Edwards’ administration chose four companies for new managed care deals slated to start in 2020: three current Medicaid contractors and one new contractor. Five companies currently do the work under deals expiring at the end of this year.

“Absent new contracts, (the health department) will be unable to provide any health care services to any Louisiana Medicaid recipients enrolled in managed care after that date,” Gee wrote.

Louisiana Healthcare Connections and Aetna Better Health currently have Medicaid managed care contracts with the state, but weren’t chosen for new deals. They filed protests Monday, accusing the health department of a biased bid review tainted by conflicts of interest.

The losing bidders want Tregre to keep the department from moving ahead with contract negotiations while protests are pending. In letters to Tregre, the companies argue there’s no risk of harm to Medicaid patients and continued work on new deals would damage their legal rights.

Both Aetna and Louisiana Health Care Connections noted that Gee assured state lawmakers, who worried about service disruptions and contract disputes, that “there’s not going to be an issue where people have no doctors.”

Health department lawyer Stephen Russo told lawmakers the agency could seek emergency contracts to keep current health plans in place if legal protests are ongoing when new contracts are supposed to start.

More than a half-million Medicaid recipients who receive coverage through Aetna and Louisiana Health Care Connections will have to transfer to new health plans if the contract awards are upheld.

Louisiana Health Care Connections said its patients shouldn’t have to “undertake the distressing and time-consuming process” of switching to new plans until legal challenges are complete.

The managed care contracts are similar to 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.


By AP reporter Melinda Deslatte

Categories: Healthcare, Today’s Business News