The charge of Act 212 of the 2013 Regular Legislative Session was to provide transparency relative to Medicaid managed care programs. Within the Office of Behavioral Health (OBH), this involves the Louisiana Behavioral Health Partnership (LBHP) and its included Coordinated System of Care (CSoC). To manage the LBHP, inclusive of CSoC, Magellan Health Services of Louisiana, Inc. (Magellan) was selected to administer the program as the statewide management organization (SMO). This report outlines responses to the requests made by the legislature in Act 212 relative to Magellan's management of care within the LBHP and CSoC.
1. The purpose of this RFP is to solicit proposals from qualified proposers that provide External Quality Review (EQR) services. Proposers must demonstrate sufficient experience performing such reviews. The current RFP seeks qualified proposers to perform an annual external quality review of the recently implemented contract for the Statewide Management Organization (SMO). This external quality review is required by the Centers for Medicare and Medicaid Services (CMS) under the Medicaid waivers that authorize the SMO and as required by §1932(c)(2) of the Social Security Act and 42 CFR Part 438, Subpart E. 2. A contract is necessary to fulfill the CMS requirements for an external review of the performance of the SMO as required by the CMS approved Medicaid waivers and the contract between the SMO and OBH.
"This is a great opportunity for behavioral health care recipients and providers to learn more about the changes we are making to expand services and improve quality of care for Louisianians," said Secretary Greenstein. "The Behavioral Health Partnership is first and foremost about improving health outcomes in Louisiana. We know we must work together to make it a success. That begins by making sure people get answers to their questions and have a voice in implementing this partnership."
The Louisiana Department of Health and Hospitals, Office of Behavioral Health, is inviting qualified proposers to submit proposals for implementing a Statewide Management Organization/Managed Behavioral Health Care Organization for the Louisiana Behavioral Health Partnership which includes both Medicaid and Non Medicaid child and adult populations.
The Department of Health and Hospitals is hosting seven weekly webinars discussing the Coordinated System of Care (CSoC) program. The webinars feature moderated discussion of CSoC operations, trainings, and a discussion of the services that will be provided to children and adults through CSoC. The webinars also feature local and national speakers giving presentations on provider issues, Medicaid requirements and other topics related to CSoC. CSoC is a collaborative between DHH, the Department of Children and Family Services, Department of Education and the Office of Juvenile Justice.
The State of Louisiana (State) is undertaking the development of a Coordinated System of Care (CSoC) for Louisiana’s at-risk children and youth with significant behavioral health challenges or co-occurring disorders in or at imminent risk of institutionalization. Louisiana leaders acknowledge that the needs of these children and their families are currently being served through a fragmented service delivery model that is not well coordinated, is many times inadequate to meet their needs and is often difficult to navigate. Further, the current system does not allow for state departments to take a coordinated approach to deliver the necessary behavioral health services. This too often results in Louisiana’s children with the highest level of needs often detained in institutional settings.