State Changes Mental Health Oversight & Payment Rules

Shared savings programs have been put on permanent hold by Louisiana’s Department of Health as the state tries to take greater control of behavioral and physical health in 2015, allowing a mix of managed care entities to enroll patients and, if appropriate, negotiate payments with providers at rates below the state’s Medicaid fee schedule. Behavioral health services here were previously managed by Magellan. The state’s Bayou Health plans will manage behavioral services this year and focus on ensuring continuity of services in the short term, then working to institute better care coordination and integration with medical/primary care services, as well as program placement and member outcomes. One new benefit to Medicaid patients under age 21 is coverage of personal care services that the department believes can help them remain in the community/at home and avoid hospitalization. Coverage is dependent on prior approval but may be available to those with a variety of severe diagnosed mental health conditions.

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