Medicaid Health Plans Respond to COVID-19 Pandemic

August 20, 2020

More than 1.6 million Louisiana residents, including many affected by COVID-19, receive health care coverage through the five Medicaid managed care organizations that make up LMMA. During the pandemic, these health plans serve a vital public health role. They partner with public health leaders to help adapt the health care system to new challenges. They assist and support healthcare providers respond to immediate needs and ensure sustainability. They coordinate care and provide support and resources to those who rely on Medicaid for their health coverage.

LMMA is committed to ensuring that Louisianans receive coordinated care for existing health conditions and have ready access to the additional support and services needed during the COVID-19 pandemic.

Informing the Evolving Response of the Health System

  • Primary research on health care providers’ telehealth capacity and needs for assistance
  • Surveillance of provider networks to identify current gaps in testing and screening
  • Analyzing data to identify root causes of disparities, offering aid to the Health Disparity Task Force, and publishing position paper, “Addressing Racial and Ethnic Disparities during COVID-19”
  • Worked with the Department of Health and the American Academy of Pediatrics to establish and provide guidance to providers and families on safely resuming immunizations and preventative care

Ensuring Uninterrupted Access to Care

  • Expanding rapid care coordination through established care management relationships
  • Broad outreach to members with high needs and at high risk, to proactively ensure both health and social determinant needs were addressed
  • Enabling early refills and 90 day supplies of prescription medications, and extending authorizations
  • Ensuring durable medical equipment (DME) availability with 90-day quantities for supplies, the extension of existing authorizations, and expanded flexibility on ventilators
  • Temporarily expanding qualifications for providers of Early and Periodic Screening, Diagnosis and Treatment (EPSDT) personal care services (PCS)
  • Implementing multi-channel education programs to support the efforts of the Office of Public Health

Expedited & Early Payments Sustaining Health Care Providers

  • Addressing short term cash flow challenges by accelerating claim payments to providers
  • Early release of hospital outpatient cost settlements
  • Expediting early payments for quality incentive and value-based payment programs
  • Created training and webinars to help providers regarding opportunities to access loans through the U.S. Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers.

Increasing Louisiana’s Health Care System Capacity

  • Expanded staffing and added 24/7 coverage to expedite rapid discharge planning
  • Waived administrative and authorization processes so clinical staff can focus on direct patient care
  • Established streamlined provisional credentialing to enable out-of-state temporary providers
  • Expediting laboratory testing and ease of payments
  • Enhanced payments for Non-Emergency Medical Transportation (NEMT) availability for COVID-19 testing
  • Donated hundreds of thousands of PPE masks, face shields and hand sanitizers to providers

Expanding Telehealth Availability

  • Encouraging patients to receive care in their homes, including telehealth and virtual wellness
  • Rapidly revised payment structures for telehealth services in close coordination with the Louisiana Department of Health
  • Implemented payment strategies for end-stage renal disease, cardiovascular monitoring, neuro-behavioral status, evaluation and management of physical health services, subsequent hospital care, subsequent nursing facility care, occupational therapy, physical therapy, and speech therapy
  • Additional focus on behavioral health services, including Licensed Mental Health Practitioners (LMHPs), Outpatient Substance Use Disorder Treatment Services and Applied Behavioral Analysis (ABA)
  • Offering free online platforms to promote, adapt and improve access to mental health screening tools to address the impacts of loneliness and isolation
  • Developed webinars to train providers on telehealth provision and billing

Addressing Social Determinants of Health

  • Funding Louisiana food banks to meet increased food needs during the stay-at-home order
  • Expanded and expedited meal delivery programs, like Mom’s Meals, for high need individuals
  • Long-standing support for the Red Cross, blood and plasma donation initiatives, and other emergency response organizations
  • Multiple partnerships with mental health associations to increase provider training and capacity and to provide direct community support statewide for increasing isolation, anxiety and depression
  • Grants to organizations providing crisis support, domestic violence intervention, childhood education and remote technology, housing, essential worker childcare and other human services