Regulators in Louisiana are attempting to crack down on a perceived pattern of physicians inappropriately steering patients into particular Medicaid managed-care plans. Doctors caught exerting such influence could be booted from the program or asked to return payments for services they provided, and they face up to $5,000 in fines, according to an emergency rule effective Dec. 1.
The rule, issued by Louisiana's Department of Health and Hospitals, targets doctors who treat patients under the state's Medicaid managed-care program known as Bayou Health. Launched last year, Bayou Health coordinates care for 888,000 beneficiaries.
Enrollees are supposed to be free to choose from one of five health plans under Bayou Health without improper outside influence. The Department of Health and Hospitals, though, has been receiving reports of doctors nudging patients to favored plans.
The Louisiana State Medical Society considers the rule's penalties “pretty draconian,” said Greg Waddell, the organization's vice president of legal affairs. To his knowledge, “steering” isn't widely practiced and may be accidental in many instances. The association is concerned, he said, that the rule was written so broadly that it will scare physicians from helping patients understand their options.
The Department of Health and Hospitals doesn't have a formal count of infractions, but Chief of Staff Calder Lynch said beneficiaries have given the department copies of letters and voice messages in which doctors display overt bias.
Follow Virgil Dickson on Twitter: @MHVDickson