The head of a statewide group of walk-in clinics emailed about 228,000 state employees, retirees, and their dependents across Louisiana, as well as all 144 legislators, trying to enlist their support in a $40 million contract dispute with the state.
Mary N. Smith, president of Access2day Health, based in Bossier City, asked subscribers to most of the health insurance plans offered to those with government jobs to call the state Office of Group Benefits, called OGB, and their legislator to ask “Why? Why? Why? Why would the new OGB management seek to cancel” a program that allows visits to no-appointment clinics without having to come out of pocket for co-pays and deductibles.
She asked for a legislative hearing. “Help us get one. We all deserve this chance to be heard and get our ‘whys’ answered,” Smith wrote.
The reason why, says Commissioner of Administration Jay Dardenne is the state is paying $40 million a year and not receiving what Access2Health promised, even though the clinics had about 50,000 visits.
“We’re supposed to be saving money, receiving a return on investment,” Dardenne said. “We’re not. It doesn’t make sense.”
The number of responses regarding Smith’s email was so overwhelming on Thursday that Dardenne said he needed to write a memo to legislators to explain the situation.
Commissioner of Administration Jay Dardenne's Feb. 11, 2021 memo to legislators explaining contract dispute with Access Health Inc.
Allied Health and the state entered into a contract in July 2019 to allow members of OGB-backed insurance plans to receive primary care services at Access2day Health clinics. Access2Health has almost 80 clinics statewide, including Acadiana Access Health in Lafayette; Patient Plus Urgent Care in Baton Rouge; Doctors After Hours in Harvey, Metairie, and New Orleans.
“The contract was premised on saving money for OGB,” Dardenne said. The contract guaranteed a ‘return on investment’ and included a surety bond backing Access Health’s performance.
“This matter is likely destined for litigation,” Dardenne wrote lawmakers. “OGB’s preference is to maintain for its members the benefits offered by Access Health.”
If the Allied Health contract is terminated, it won’t affect the other health plans the state offers its employees.
When David Couvillon took over as chief executive officer of the Office of Group Benefits on Oct. 21, he began reviewing contracts and found that Access Health wasn’t delivering anywhere near $40 million worth of services as it was contractually obligated to do, Dardenne said.
OGB and Access Health began negotiations but failed to get anywhere. The state wants Access Health to accept a lower payment.
When talks failed, the state served notice last week that that it intended to terminate the contract on April 9. “Unfortunately, the Access2day Health program has not performed as expected,” OGB wrote in a memo.
Subscribers are still allowed to go to primary care and urgent care clinics, but after April 9, they will be charged copays, coinsurances, and deductibles.
Access Health’s Smith did not return calls Thursday seeking comment.
Email sent by Access2day Health to state workers, retirees and dependents who get their health insurance from one of the plans offered by the …
But in her email to state workers, Smith alluded to a possible COVID-19 pandemic reason.
She noted in her email that the pandemic “limited your visits from March to present … Hospitals were overwhelmed, citizens were told to stay home, those with symptoms were told to stay home unless they worsened and instructions from the CDC (the federal Centers for Disease Control and Prevention) changed daily.”
The state in April 2020 required paperwork from Access Health in a request for federal relief funds. But Smith wrote she was never informed about the results of that application.
Also, other vendors with the Office of Group Benefits “was granted a COVID-19 contract waiver except for Access2day Health,” Smith wrote.
Smith noted that state employees gave the clinics a 92% satisfaction rating.