FY2018 Transparency Report from Act 158 of the 2015 Regular Legislative Session

The charge of Act 158 of the 2015 Regular Legislative Session was to provide transparency relative to Medicaid managed care programs. Within the Office of Behavioral Health (OBH), this involves the Coordinated System of Care (CSoC) program. Magellan Health Services of Louisiana, Inc. (Magellan) administers the CSoC program. This report outlines responses to the requests made by the legislature in Act 158 relative to Magellan's management of care within CSoC program.

FY 2018 CSoC Annual Report

Appendices:

• APPENDIX I: HEALTHCARE PROVIDERS IN EACH PARISH BY PROVIDER TYPE, APPLICABLE CREDENTIALING STATUS, AND SPECIALTY
• Detailed Provider List (Excel Format)
• APPENDIX II: CHILDREN RECEIVING SERVICES THROUGH CSOC BY PARISH
• APPENDIX III: PERCENTAGE OF REFERRALS CONSIDERED IMMEDIATE, URGENT AND ROUTINE
• APPENDIX IV: CLEAN CLAIMS
• APPENDIX V: TOP FIVE CLAIMS DENIAL REASONS
• APPENDIX VI: PERCENTAGE OF MEMBERS ASKED TO PROVIDE CONSENT FOR RELEASE OF INFORMATION TO PRIMARY CARE PHYSICIAN
• APPENDIX VII: REPORT ON QUALITY MANAGEMENT
• Quality Program Description (January 1,2018–October 31, 2018)
• Utilization Management and Care Management Program Description (2018)
• Louisiana Coordinated System of Care Annual Evaluation of the Quality Program (January 1,2018–October 31, 2018)
• APPENDIX VIII: TOTAL FUNDING PAID FOR CLAIMS TO PROVIDERS, ADMINISTRATIVE COSTS AND PROFIT