§ 40:2252 — Participation in state health care delivery system required

§2252. Participation in state health care delivery system required
A. Any health care delivery system established by the state, pursuant
to a federal Medicaid waiver, to provide health care to any person otherwise
eligible for Medicaid and to any indigent, uninsured, or underinsured person
shall recognize and include essential community providers as available and
required in the health care delivery systems and networks.
B. Any basic benefits plan that may be established under a health
maintenance organization, health insurance organization, or managed care
organization that contracts with the state to provide or coordinate to provide
health care services to any person otherwise eligible for Medicaid and any
indigent, uninsured, or underinsured person shall include essential community
providers as available and required as active medical and health professionals.
C. The Louisiana Department of Health shall promulgate rules and
regulations, in accordance with the Administrative Procedure Act, which shall
include, but not be limited to, the establishment of minimum levels of
participation of essential community providers in such plans. Any plan
provider that fails to maintain the minimum level of participation as
determined by the department shall be subject to penalties, including
revocation of any authority to participate in the state program or a prohibition
on enrolling new members as determined by the department.

Legislative History

Acts 1995, No. 1282, §1, eff. June 29, 1995.