As part of the transition of specialized behavioral health services into Bayou Health, additional Medicaid members not previously enrolled in Bayou Health will now be able to get care through a Bayou Health Plan, in addition to those already enrolled in Bayou Health who will now have a single-source for the physical and behavioral health care. This transition has created four (4) main categories of coverage in Bayou Health. These include enrollees who have coverage for:
We’ve long known that our ultimate goal was the integration of behavioral and acute care services once the systems in place had matured. We began working on the next phase of both Bayou Health and the LBHP well over a year ago. Since then, we’ve continued to look at the best practices across the country and the capabilities of our contracted partners. As a result, the Louisiana Department of Health and Hospitals will be integrating all specialized behavioral health care services into its Medicaid Managed Care program known as Bayou Health. Beginning Dec. 1, 2015 most patients who previously accessed care through Magellan (also known as the Louisiana Behavioral Health Partnership) will now get their specialized behavioral health care directly from their Bayou Health Plan. If they do not currently have a Bayou Health Plan, they will be given the opportunity to choose one prior to integration. Magellan will continue to manage a small group of children identified with a high level of risk of out of home placement that are referred to the Coordinated System of Care program (CSoC) for their specialized behavioral health and other wrap around support services.
Providers will continue to bill Magellan for specialized behavioral services for dates of service through 11/30/2015 and should maintain their contractual agreements through this period. Beginning 12/1/15, the SMO contract with Magellan will terminate for all but the CSoC population, and claims will then be submitted to the respective member’s Bayou Health Plan for all Medicaid services. With the exception of CSoC services, authorizations, reimbursement, and all other managed care functionality for Medicaid services will flow through Bayou Health effective 12/1/15. Between now and Dec. 1, there are no changes to patient’s benefits or how they get care.
All five of our health plans that have been awarded contracts have extensive experience managing specialized behavioral health services in their other plans across the country. Each of these plans has an affiliated company as part of their corporate parent, meaning services will be truly integrated and coordinated and not subcontracted out to a third party plan. We are very confident in their ability to administer these services and continue to build out the provider network, and will be working over the next year to ensure that they are prepared on day one.
The Office of Behavioral Health (OBH) issued a Request for Information (RFI) in February to solicit interest in the administrative management of this population. Based on these responses, recenetly received in March of 2015, OBH issued a Request for Proposals (RFP) to solicit bids from potential contractors on Aug. 28, 2015. Please visit the following link to check for the RFP posting: http://new.dhh.louisiana.gov/index.cfm/newsroom/category/47
The Department will consider the current LBHP Medicaid State Plan amendments and waivers and the LBHP service definitions manual to build a comprehensive and robust behavioral health care benefit package within Bayou Health. The Department will be working with key stakeholders and through this advisory group, will assess any changes that may need to be made. Notification of any changes in benefits upon transition will be communicated to the providers and members through Magellan, the Bayou Health Plans, the Department and informational bulletins.
DHH launched the Integrated Health Care webpage dedicated to the transition of the Louisiana Behavioral Health Partnership into Bayou Health. This webpage is continuously updated with transition related information, including Frequently Asked Questions.
You can access the integrated health care page through www.MakingMedicaidBetter.com. Click on the "Behavioral Health" tab.
You can review the Informational Bulletins at www.MakingMedicaidBetter.com for the latest integration details, or you can sign up to have these delivered direct to your inbox through the "Subscribe" tab on the right hand side of the home page at www.MakingMedicaidBetter.com. Select "Bayou Health" to get only Bayou Health information, that includes Informational Bulletin updates. Select "All Department News" to get information on all DHH programs.
You may also speak directly with your provider relations contact with your Bayou Health plan. All claims or provider enrollment questions should be directed to the Health Plan.