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Senate committee hears LDH plan to move Medicaid physician fees toward Medicare parity; lawmakers seek code-level cost detail
Summary
LDH presented a two-year plan under Act 306 / SB 190 to bring Medicaid physician reimbursement toward Medicare parity (85% year one, 100% year two). Lawmakers praised the goal but pressed LDH and Milliman for code-by-code impacts after examples showed some CPT codes could fall sharply.
BATON ROUGE — The Senate Health and Welfare Committee on Dec. 17 held an oversight hearing on the Louisiana Department of Health's plan to raise Medicaid physician reimbursement toward Medicare parity under Act 306 (Senate Bill 190), hearing both an agency overview and pushback from members and provider groups.
LDH officials described a two-year glide path: move the Medicaid physician fee schedule to about 85% of Medicare in year one and to Medicare levels in year two, with an expanded set of CPT codes intended to support care coordination. An LDH official told the committee the proposal is intended to improve access, saying coverage does not always mean access for the state's roughly "1,700,000" Medicaid enrollees and that case management codes would encourage primary care providers to accept more Medicaid patients.
The Department's actuarial contractor, Milliman, told the committee the model shows an aggregate increase in physician reimbursement once the schedule moves to Medicare levels and that first-year…
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