A state House panel decided Tuesday that lawmakers should be able to stop the Jindal administration’s new health-care delivery system for the poor if it’s not working.
The Health and Welfare Committee voted 12-2 to send the Senate-passed legislation to the House for debate.
State health agency officials did not testify against the legislation, but are working behind the scenes to defeat it.
Jindal press secretary Kyle Plotkin said the governor is “watching the bill” when asked about a potential veto.
Approval of the measure came over the objection of committee Chairwoman state Rep. Kay Katz, R-Monroe, who wanted lawmakers to receive reports on the program’s progress and recommend changes.
But Senate Bill 207’s sponsor, Senate health panel Chairwoman Willie Mount, said lawmakers need to be in a position to halt the program if it is not meeting the health-care needs of constituents and alienating providers.
“We need the legislative branch, an equal branch, to have a part as we move forward with this managed-care option,” said Mount, D-Lake Charles.
Gov. Bobby Jindal’s health agency is preparing to phase in “community care networks,” statewide starting in 2012 in the New Orleans area.
Under the plan, private insurance companies or other third-party entities would be responsible for the care of two-thirds of the state’s 1.2 million Medicaid recipients — mainly children.
The insurers, or third-party entities, would develop health-care networks of physicians, hospitals and others to provide patient care under either a pre-paid or shared-risk model — all financed with billions of taxpayer dollars.
The CCN plan has been controversial from the start, with health-care providers and lawmakers complaining that it diverts health-care dollars into insurance company profits.
State Sen. Joe McPherson, D-Woodworth, said Jindal bypassed the Legislature to embark on the program — a major change in the way health care is delivered for lawmakers’ constituents.
Now its only recourse is to monitor the program closely — using the same performance criteria in contracts — and have authority to cancel it, McPherson said.
McPherson said Jindal “slipped” language in the state budget bill authorizing the program after lawmakers had rejected the idea, then tried to implement it by emergency rule, which lawmakers stopped.
Under SB207, the state Department of Health and Hospitals must submit an annual report concerning the CCN program to Senate and House committees on health and welfare beginning Jan. 1, 2013. The information required parallels standards DHH will use to monitor the networks performance.
In addition, the Legislature’s health and budget panels must receive quarterly reports DHH receives from the CCNs.
Within 90 days of receipt of the Jan. 1, 2014, annual report, either the joint budget committee or the legislative health committees, meeting jointly, can determine whether the coordinated care network program should be terminated.
Katz objected to legislative committees having the authority to end a program.
“I don’t have a problem with the transparency in here. The reports are excellent,” Katz said. “My problem is that a committee can terminate a huge program like this.”
Katz’s stance mirrored comments released later in the day by DHH communications director Lisa Faust.
If the CCNs are doing what they are supposed to be doing, there won’t be a need for a committee meeting to discuss the program’s end, Mount said.
“When you think about the huge amount of money and the folks it’s going to impact, how are you going to be able to help your constituents unless you are treated as an equal branch of government?” Mount asked.
Katz lost — on a 6 to 9 vote — an attempt to alter the bill to strip termination authority.
Supporting the measure were the Louisiana Hospital Association, the Louisiana State Medical Society, Medicine Louisiana, the Advocacy Center and the American Academy of Pediatrics, Louisiana Chapter.