White Coat Wednesday
Administrative Simplification
Rep. JP Coussan - HB 339 - Coordination of Benefits
Prohibits a health plan from pending, delaying, or denying payment to a healthcare provider for rendered healthcare services on the basis of the insured's failure to provide the health insurance issuer no � ce of the existence of other insurance. Health plans are holding and denying claims solely because their insured has not provided them with the paperwork regarding other insurance. It is not the health care provider’s responsibility to track down pa � ents to have them sign insurance forms. Pa � ents are o � en already discharged from the hospital and cannot be located, leaving the provider without payment.
Sen. Fred Mills & Rep. Larry Bagley - SB 59 - Prepayment Review
Prohibits a Medicaid managed care organiza � on or its contractor, assignee, or agent from requiring any enrolled provider to be subject to prepayment review unless the requirement is implemented directly by the La. Dept. of Health and in accordance with the provisions of the Medical Assistance Programs Integrity Law. Managed care organiza � ons con � nue to a � empt to implement unnecessary, burdensome u � liza � on review tac � cs that result in payment delays or denials for care that has already been provided.
Rep. Chris Turner - HB 286 - Medicaid Credentialing
S � pulates that any healthcare provider who maintains hospital privileges or is a member of a hospital medical sta ff with a licensed hospital shall be considered to have sa � s ed, and shall otherwise be exempt from having to sa � sfy, any creden � aling requirements of a Medicaid managed care organiza � on. Medicaid providers must submit creden � aling and re ‐ creden � aling informa � on separately to EACH of the FIVE Medicaid managed care organiza � ons with whom they contract. This bill would alleviate that signi cant burden and authorize the Medicaid MCOs to recognize hospital medical sta ff privileges. Manual Ɵ me consuming administra Ɵ ve burdens divert valuable resources away from direct pa Ɵ ent care.
Working Together to Keep Physicians in Patient Care Louisiana State Medical Society Louisiana Academy of Family Physicians LA Chapter - American Academy of Pediatrics LA Chapter - American College of Emergency Physicians LA Chapter - American College of Physicians LA Chapter - American College of Surgeons Louisiana Dermatological Society LA Academy of Eye Physicians and Surgeons Louisiana Medical Association Louisiana Orthopedic Association Louisiana Osteopathic Medical Association/VCOM Louisiana Pathology Society Louisiana Psychiatric Medical Association Louisiana Society of Addiction Medicine Louisiana Society of Anesthesiologists Louisiana Society of Interventional Pain Physicians Medicine Louisiana Radiological Society of Louisiana
PhysicianLedMed | physiciancoali Ɵ on.org
J LA MED SOC | VOL 174 | SUMMER 2022 21
Made with FlippingBook Digital Publishing Software