Aug 18, 2014 11:50 AM by AP
BATON ROUGE, La. (AP) - An annual report evaluating Gov. Bobby Jindal's privatization of Medicaid lacked important financial information and presented rosy performance reviews not corroborated by data, according to a review released Monday.
Legislative Auditor Daryl Purpera's office raised questions about the report that Jindal's Department of Health and Hospitals submitted to lawmakers in January. It analyzed the performance of the private managed-care networks handling Medicaid services.
Under a state law enacted in 2013, the department is required to submit a yearly report about the performance of the Bayou Health program, an insurance-based model that covers 900,000 of Louisiana's 1.4 million Medicaid recipients, mostly pregnant women and children.
The auditor's non-partisan review said the report included "mathematical errors and inconsistencies" and used primarily self-reported data from the managed-care organizations that the department didn't appear to verify.
"The report included global assertions about Bayou Health cost savings and improved outcomes ... but support was not provided for these assertions," auditors wrote.
In the department's written response, Medicaid Director Ruth Kennedy disagreed with the auditor's review, saying the department provided the best data possible and the auditor's office "does not paint a complete picture."
"The department continues to disagree with the basis of many of the findings," Kennedy wrote.
Jindal privatized much of the Medicaid program in 2012, shifting two-thirds of its patients to the insurance model. Medicaid recipients in Bayou Health choose from - or are assigned to - one of five privately operated networks of primary care doctors, specialists and hospitals.
Lawmakers wanted details of whether the privatization delivered the improved health outcomes and cost savings that the Jindal administration promised for the multibillion-dollar Medicaid program.
Purpera's office said the report submitted by the health department covered only July 2012 through June 2013, leaving out the first five months of the Bayou Health program.
Auditors also said the report didn't include data that allowed comparisons between Bayou Health and the previous method for handling Medicaid patient care, though that was the intention of lawmakers who sought the report.
"This lack of comparability renders most comparisons of Bayou Health data to legacy Medicaid data skewed and not useful," auditors wrote.
In her response, Kennedy the requirement was signed into law fewer than seven months before the first report was due, giving DHH a "very narrow window of time" to compile and analyze data.
She said the department has a verification process to check information submitted by the managed-care organizations and also has contracted with an outside accounting firm to do additional accuracy reviews.
"The Bayou Health Transparency Report represents an unprecedented compilation and publication of Medicaid data, much of which was not collected or reported on for our legacy Medicaid program," Kennedy wrote.
The auditor's review comes as existing managed-care contracts are expiring and the Bayou Health program is under scrutiny from state lawmakers as the health department is taking new bids from companies interested in participating in the program.