BAYOU HEALTH Newsletter 1.27.2012

First Recipients to "Go Live" with BAYOU HEALTH Next Week

Next week, the first group of recipients will transition to BAYOU HEALTH, when GSA A goes live on Wednesday, Feb. 1.

All eligible recipients in GSA A, which comprises the New Orleans and Northshore areas, will be enrolled in a BAYOU HEALTH Plan by Feb. 1 so they can begin receiving health care services through this model on the go-live date. The go-live date does not end a recipients' ability to choose or change Health Plans. Recipients have 90 days from the date of the letter telling them the name of their Health Plan to contact the BAYOU HEALTH Enrollment Center and change Plans, if they wish to do so. After the 90-day window, recipients will have an annual enrollment period, but can change Health Plans at any time if they have a good reason to do so (e.g. moving to another area of the state, needing to see a doctor in another Plan). If recipients do not feel the Health Plan they are enrolled in is a good fit for their family, they can call 1-855-BAYOU-4U and have an enrollment agent assist them in finding the right Plan.

The next area of the state to implement BAYOU HEALTH will be GSA B, which encompasses the Capital Area, South Central Louisiana and Acadiana regions. The go-live date for GSA B is April 1. Eligible enrollees in these regions will receive a BAYOU HEALTH Enrollment Packet that outlines their Health Plan choices beginning in mid-February. BAYOU HEALTH staff will begin hosting events in GSA B in late February, to give recipients time to review their Enrollment Packets, and then have an opportunity to meet in person and get information to pick their Health Plans. A schedule of GSA B enrollment events is available on www.MakingMedicaidBetter.com.

BAYOU HEALTH will be implemented statewide by June 1. Recipients who wish to select a Health Plan should call 1-855-BAYOU-4U (1-855-229-6848) to speak with an enrollment agent or use the automated voice cues to enroll in a plan, attend an enrollment outreach event, enroll online at www.bayouhealth.com, or fill out the paper forms that come in the BAYOU HEALTH Enrollment Packet and mail or fax these back to the Enrollment Center.

BAYOU HEALTH Advocates' Conference Will Take Place in Lafayette Feb. 1

Department of Health and Hospitals Secretary Bruce D. Greenstein invites you to the BAYOU HEALTH Advocates' Conference from 9 a.m. to 2 p.m. on Wednesday, Feb. 1, at the Holiday Inn at 2032 Northeast Evangeline Thruway in Lafayette. The purpose of this conference is to share information with health care advocates and get their feedback on the department's education and outreach plans to inform Medicaid and LaCHIP recipients about new choices available through BAYOU HEALTH.

This conference is specifically designed for community-based organizations and other advocates who work with Medicaid and LaCHIP recipients, so their members can assist DHH in educating recipients about the changes coming through BAYOU HEALTH and help people better understand the enrollment process, as recipients will be asked to choose a Health Plan for their families. DHH held the first BAYOU HEALTH Advocates' Conference in Baton Rouge in October 2011. The Feb. 1 Advocates' Conference will follow the same structure and format, so advocates who participated in the first conference do not need to attend the second one. DHH is launching BAYOU HEALTH in phases for different areas of the state. All eligible Medicaid and LaCHIP recipients will transition to the BAYOU HEALTH model by June 1.

There is no cost to attend the summit, but all attendees must register in advance. If registration exceeds the allotted amount of spaces, participants representing GSA B (the Capital Area, South Central Louisiana and Acadiana regions) will be given preference, and a future conference will be scheduled for participants from other GSAs. If we need to decline your registration because of space, we will send you an email informing you of this.

For more information about BAYOU HEALTH, please visit www.MakingMedicaidBetter.com or email bayouhealth@la.gov. The Registration Form is available online.

Updates for Providers:

Communications with Your Non-BAYOU HEALTH Patients

When BAYOU HEALTH is fully implemented by June 1, nearly two-thirds of the State's Medicaid recipients, which includes most of the patients currently linked to medical homes through the CommunityCARE program, will have their health care services delivered and coordinated by a BAYOU HEALTH Plan. Other recipients, many of whom have complex medical needs, will remain in the current Medicaid fee-for-service program.

If you have Medicaid or LaCHIP patients who are receiving waiver services or are on the waiver registry, are in hospice, a long-term care center or developmental disabilities center, receive Medicare, or receive Medicaid through the LaCHIP Affordable Plan, Louisiana Health Insurance Premium Payment (LaHIPP), TAKE CHARGE (family planning), or Greater New Orleans Community Health Connection (primary care services waiver) programs, they will not receive their services through a BAYOU HEALTH Plan. If you wish to continue treating your patients in these groups, you must maintain your enrollment as a Medicaid fee-for-service provider through DHH's fiscal intermediary, Molina. You will continue providing services to them and billing for payment just as you do today. Providers can be both a Medicaid fee-for-service provider and sign up with as many BAYOU HEALTH Plans as they wish to treat Medicaid patients.

All Medicaid recipients who are required to enroll in a BAYOU HEALTH Plan, along with those who can voluntarily enroll, receive an Enrollment Packet that outlines their choices. You are welcome to let your patients know which Health Plans you have contracted with so they can select a Plan that includes you. BAYOU HEALTH staff have created a flier that you can fill out and give to your Medicaid patients to list your Health Plan participation. Please be aware that your Medicaid patients who are not part of BAYOU HEALTH implementation will not receive an Enrollment Packet, and they do not have to enroll with a Health Plan to continue receiving services. Please be ready to let these patients know whether you will remain a regular Medicaid fee-for-service provider. Many of them will want to make sure they can continue seeing their current Medicaid primary care provider under the fee-for-service program.

If you have questions or want more information about which patients are part of BAYOU HEALTH and which are not, please email bayouhealth@la.gov. If you wish to become a Medicaid fee for service provider, enrollment details are available at www.lamedicaid.com.

Important Information About BAYOU HEALTH for Non-Emergency Medical Transportation Providers

As the state progresses with BAYOU HEALTH implementation, non-emergency medical transportation (NEMT) providers should know how these trips will be authorized and scheduled, and where they should submit their claims for payment. Please review each Plan's authorization and claims processes.  A flier detailing the differences among the five Health Plans, including which contractor each will use for NEMT services, is also available.

Electronic Claims Information Available for BAYOU HEALTH Plans

The five Health Plans have issued their Electronic Data Interchange (EDI) information so providers can see how to contact each Plan for assistance in submitting online claims for payment. Please review the EDI Submission Information for the BAYOU HEALTH Plans.

Contact Us

BAYOU HEALTH is the State's new approach to delivering and financing health care for nearly 900,000 Medicaid and LaCHIP recipients. Under BAYOU HEALTH, DHH has contracted with five private Health Plans responsible for coordinating and managing the care of their members to improve health outcomes while controlling costs in the program.

For the latest information about BAYOU HEALTH, please visit www.MakingMedicaidBetter.com or the enrollment website, www.bayouhealth.com. To share your comments or ask questions, email bayouhealth@la.gov. Call toll-free 1-855-BAYOU4U (1-855-229-6848) to speak with an enrollment counselor for assistance in picking a Health Plan.