Nov 20, 2009 10:26 AM by Department of Health and Hospitals
Louisiana Medicaid Recognized as a National Best Practice for Administrative Efficiency
Despite one of lowest administrative costs in nation and 15 percent reduction in eligibility staff, Louisiana Medicaid shows significantly lower error rates, keeps nearly 100 percent of qualified kids on rolls
BATON ROUGE- Louisiana Department of Health and Hospitals Secretary Alan Levine today announced that the U.S. Centers for Medicare and Medicaid Services (CMS) has recognized Louisiana's Medicaid program as a national best practice for its efforts to simplify and streamline the state's Medicaid eligibility processes. Louisiana's Medicaid program, which includes the Louisiana Children's Health Insurance Program (LaCHIP), also shows significantly lower error rates overall than the national average, according to reports released by CMS.
According to CMS, the national overall Medicaid estimated error rate is 8.71 percent, while Louisiana's estimated overall error rate is 3.96 percent due to the state's efforts to modernize and streamline the program. Louisiana Medicaid was cited as a national best practice for eligibility procedures due to a Medicaid estimated eligibility error rate of 1.54 percent, compared with the national estimated eligibility error rate of 6.74 percent. Medicaid estimated error rates are determined by CMS' Payment Error Rate Measurement (PERM), which measures unintentional billing errors by providers and administrative errors by state agencies in the Medicaid and Children's Health Insurance programs.
DHH's Medicaid Eligibility Division attributes the low error rate to their efforts to modernize and simplify the eligibility determination and renewal processes without sacrificing the integrity of the program. This allows the state to keep nearly 100 percent of all qualified kids enrolled at renewal, while other states lose up to 50 percent of children at renewal. This has been accomplished in spite of a 15 percent reduction in eligibility staff over the past year due to budget reductions.
"The Governor has challenged us to do more with less, and we take that charge seriously," said Secretary Levine. "Our Medicaid program is one of the most efficiently operated programs in the nation, and the result is an eligibility process with fewer errors, lower administrative cost, and a more friendly process for families."
Cindy Mann, Director of the U.S. Department of Health and Human Services Center for Medicaid and State Operations, said "Louisiana has long been a leader in establishing simple, common sense methods for enrolling and renewing eligible children and families in Medicaid and CHIP. At the same time, the new data just released by CMS shows that the state has one of the lowest Medicaid error rates in the country. Its impressive track record in both arenas shows that program integrity can go hand in hand with enrollment success."
Additionally, Joan Alker, Co-Executive Director of the Center for Children and Families at Georgetown's Health Policy Institute said, "The fact that Louisiana has achieved such a high rate of accuracy in its Medicaid program is validation that its innovative approach works well. LaCHIP leads the nation in removing red-tape from the Medicaid eligibility and renewal process and now it leads the nation in the accuracy of its eligibility determinations. The secret of their success is putting commonsense to work by reducing paperwork and bureaucratic hurdles from the renewal and eligibility process and empowering frontline managers to make decisions."
Also, a recent report by the Georgetown Center for Children and Families regarding Medicaid retention rates states that "Louisiana's experience serves as a model for retention policy and process improvements...The Louisiana experience demonstrates that is it possible to eliminate virtually all procedural closings at renewals."
In recent years, Medicaid has all but eliminated paperwork-related reasons from keeping children off renewal rolls. Because of these efforts, in October, Louisiana kept nearly 100 percent of children up for renewal, at more than 99.5 percent. As a comparison, other states around the country lose between 25 and 50 percent of children at renewal for failure to return paperwork. This has been made possible by a variety of factors, including maximizing the use of technology and reducing the documents families must produce. For example, applicants used to have to provide copies of their birth certificate, which Medicaid now accesses directly in conjunction with the Center for Records and Statistics. Also, instead of requiring eight consecutive paycheck stubs to verify employment, Medicaid now requires two, working with state databases and telephoning employers to verify additional information.
Medicaid works hand-in-hand with the Department of Social Services' Office of Family Services, which runs the state's SNAP (formerly Food Stamp) program, as well as the Louisiana Workforce Commission, to verify income through their databases without placing additional burdens on the applicant. An added benefit to paperless processes and simplification is administrative savings and "green government."
The Louisiana Department of Health and Hospitals strives to protect and promote health statewide and to ensure access to medical, preventive and rehabilitative services for all state citizens. To learn more about DHH, visit http://www.dhh.louisiana.gov.