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Wednesday, April 17, 2019

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Health department revamps Medicaid expansion hiring plan

Health department revamps Medicaid expansion hiring plan

BATON ROUGE, La. (AP) — Gov. John Bel Edwards' administration is reworking its approach to hiring the staff needed to handle his Medicaid expansion effort, after getting pushback from lawmakers who bristled at adding employees to a state government brimming with budget problems.

"We're not hiring staff anymore because the Legislature spoke very clearly," said Jeff Reynolds, chief financial officer for the Department of Health and Hospitals.

The agency initially proposed adding nearly 250 new workers to handle enrollment of the thousands of people expected to qualify for Medicaid under an eligibility expansion. But the hiring proposal was put on hold in January as the Democratic governor's administration ran into concerns from Republican lawmakers.

Under a revised plan, the Edwards administration might be able to sidestep lawmakers.

The health department now intends to beef up an outside contracting deal with the University of New Orleans to augment agency staff. Reynolds said UNO will have as many as 200 short-term employees who will do the eligibility review for Medicaid expansion.

"They do all the leg work. A DHH employee will do the final determination" of whether someone vetted by the outside workers is eligible for the Medicaid coverage, Reynolds said.

Health department spokesman Bob Johannessen said Monday that the agency was determining whether the contracting arrangement requires legislative approval for the spending.

It's unclear when the short-term workers under the UNO contract will start reviewing who could be eligible for the expanded health insurance program. Edwards wants to have government-funded health insurance cards in more people's hands by July 1, when the new budget year begins.

The staffing contract with UNO, Reynolds said, would cost about $9 million to $10 million, and would be paid for by both the state and federal governments. The state's estimated $2.9 million share would be paid by health providers such as hospitals and managed-care plans that stand to benefit from the influx of new Medicaid funding.

It's an unusual financing method that Louisiana hasn't used previously.

The Baton Rouge Area Foundation will collect the money, which will be considered a charitable donation. The foundation will send the money to the health department without telling the agency which providers made donations, according to a document filed with federal officials.

The federal Medicaid agency agreed to the financing plan, Reynolds said. The health department didn't consult with the state ethics board about the arrangement, Johannessen said.

Reynolds said he's "not overly optimistic" that providers will continue to give the donations next year. That means the state would have to pay its share of the administrative cost, though Reynolds said even with that expense, Louisiana still is estimated to save more than $100 million on the Medicaid expansion in the new budget year.

The Edwards administration estimates at least 375,000 additional people, mainly the working poor, will be added to Louisiana's Medicaid program under the expansion, which covers adults making up to 138 percent of the federal poverty level, or about $33,400 for a family of four.

The federal government will pick up the full cost of the health services for a short period of time. Louisiana will later have to pay a share that eventually will increase to 10 percent.

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