§978.2. Health care delivery system

A. The department shall develop and implement a medical home system of care for Medicaid recipients and the low-income uninsured citizens of the state. The medical home system of care shall:

(1) Coordinate and provide access to evidence-based health care services, emphasizing convenient, comprehensive primary care.

(2) Provide access to appropriate specialty care and inpatient services.

(3) Provide quality driven and cost-effective health care.

(4) Promote strong and effective medical management.

(5) Emphasize patient and provider accountability.

(6) Prioritize local access to the continuum of health care services.

B. The department shall require providers who participate in the medical home system of care to adopt an interoperable electronic medical record.

C. In order to ease the cost of implementation of health information technology, the department shall avail itself of any public and private funding available.

D. The department may establish a mechanism to evaluate, promote, and improve the quality of health and health care delivered to the Medicaid and low-income uninsured populations through the use of quality performance measures, evidence-based standards of care, and other measurements that facilitate quality improvement.

E. Reimbursement for participation in Louisiana Health First shall be at a level to ensure provider participation and success. The department shall develop an enhanced Medicaid reimbursement methodology to compensate providers who participate in the medical home system of care. The department shall also apply to the Centers for Medicare and Medicaid Services for authority to develop a payment methodology to compensate providers who care for the low-income uninsured in the medical home system of care. To the extent permitted by the federal government, such reimbursement methodologies shall incorporate features of successful managed care programs, which promote the medical home system of care that is supported by the appropriate, enforceable, quality standards of evidence-based medical protocols and the necessary health information technologies.

F. Reimbursement for health care services for low-income uninsured individuals provided under the medical home system of care shall be allocated to the greatest extent possible based on the disbursement of the low-income uninsured population statewide.

Acts 2007, No. 243, §1.