Health Care Providers
The state, through the Department of Health and Hospitals, is moving away from the current Medicaid fee-for-service system and more effectively managing Medicaid enrollees' health care through the implementation of BAYOU HEALTH.
Louisiana's Medicaid providers deliver a valuable service to the state's Medicaid recipients, and their continued input and participation are critical as the state works to create a care delivery system that leads to better health outcomes and more effectively coordinates services and treatment.
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Important Information About BAYOU HEALTH for Medicaid Waiver Recipients
All Medicaid recipients enrolled in one of the Louisiana Medicaid waivers (New Opportunities or NOW, Children's Choice, Supports, Adult Day Care, Community -- formerly called Elderly and Disabled Adult or EDA) are not included in BAYOU HEALTH implementation. These recipients will not be enrolled in one of the five Health Plans.
Medicaid waiver services recipientswill continue to access their health services through the "regular" Louisiana Medicaid Program, just as they do now.
One key change is that waiver recipients age 21 and older will no longer be enrolled in CommunityCARE once BAYOU HEALTH goes live in the Regions in which they reside (February 1 for Regions 1 and 9; April 1 for Regions 2, 3 and 4; and June 1 for Regions 5, 6, 7 and 8.) Once BAYOU HEALTH takes effect, waiver recipients willno longer need a referral to see a specialist, unless the specialist requires one. DHH anticipates that the overwhelming majority of current Medicaid providers will continue providing health care services to recipients through the regular Medicaid program as well as to those who are enrolled in a Medicaid Health Plan through BAYOU HEALTH.You can contact yourprovider's office directly to find out whether he or she plans to continue seeing regular Medicaid patients once BAYOU HEALTH takes effect.
Some physicians have or will mail letters to their patients who have Medicaid coverage urging them to select a BAYOU HEALTH plan. The physicians do not have any way of identifying their Medicaid patients who are not included in BAYOU HEALTH and not required to enroll in a Health Plan, so waiver enrollees may receive one of these letters from a physician.
Recipients who are supposed to select a Health Plan as part of BAYOU HEALTH will receive an Enrollment Packet from the BAYOU HEALTH Enrollment Center. These packets are sent directly to the recipients, and contain information about each of the Health Plans. If you are a Medicaid waiver services recipient, you are not included in BAYOU HEALTH, will not receive an Enrollment Packet, and do not need to select a Health Plan. Please disregard any letters you receive from a physician urging you to pick a plan if you are a waiver services recipient.
Recipients between the ages of 3 and 21 who are on the Registry (waiting list) for the Children's Choice and/or NOW Medicaid waiver are not included in BAYOU HEALTH and will not receive an Enrollment Packet from the BAYOU HEALTH Enrollment Center.
Questions regarding BAYOU HEALTH implementation and Medicaid waiver recipients can be directed to bayouhealth@la.gov.
CommunityCARE 2.0
CommunityCARE, DHH’s primary care case management program that links Medicaid recipients to a primary care provider, recently transitioned to an enhanced version, which incorporates pay-for-performance measures. The new program, known as CommunityCARE 2.0 (CC 2.0), provides greater coordination of care for Louisiana’s vulnerable Medicaid populations and creates a bridge toward coordinated care network implementation.
Details of the program, including additional information on pay-for-performance measures and rates, can be found at www.la-communitycare.com.In addition, DHH has posted CommunityCARE 2.0 Utilization Reports – a Web-based application that shares detailed information on the services utilized by CommunityCARE enrollees. CommunityCARE 2.0 providers may access their utilization reports at www.laMedicaid.com, or may review the instructions for accessing the reports by clicking here.
Electronic Health Records (EHR) Incentive Program
Registration is now open for the Louisiana Medicaid Electronic Health Records Program (EHR), through which eligible medical professionals and hospitals can receive incentive payments for adopting, implementing or upgrading certified EHR technology during their first year of participation, and can earn payments for up to five subsequent years for demonstrating meaningful use of EHR.
