Effective Dec. 1, the rule was enacted in response to reports of physicians steering patients to a preferred program under Bayou Health, the state’s Medicaid managed-care program. The new rule seeks to “ensure the integrity of Medicaid recipients’ freedom of choice in choosing a particular health plan in which to enroll and, when eligible, the freedom of choice in deciding whether or not to receive care through Medicaid fee-for-service.”
Determination of breaches of this new rule will be made by the state Department of Health and Hospitals. In addition to the fine and possible exclusion from the program, the provider may also be required to inform the patient in question of the sanction and the patient’s right to choose another plan.
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