La. health secretary defends Medicaid report, criticized by legislative auditor as skewed

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BATON ROUGE, Louisiana — Louisiana's health department said Wednesday that its evaluation of the state's Medicaid privatization was on target, despite criticism from the legislative auditor that it lacked key data and contained inconsistencies.

The auditor's office told lawmakers the report from the Department of Health and Hospitals had mathematical errors, offered skewed comparisons and presented unsubstantiated performance reviews.

DHH Secretary Kathy Kliebert disagreed with the auditor's findings.

"We don't believe it paints a complete picture concerning what we thought was a really good response to what was requested," Kliebert told the Legislative Audit Advisory Council, a legislative panel that oversees the auditor's work.

A yearly report analyzing the performance of the private managed-care networks handling Medicaid services through the Bayou Health program is required under a 2013 state law. Gov. Bobby Jindal's administration submitted its first report to the Legislature in January.

"The report has numbers that you can't rely on," said Legislative Auditor Daryl Purpera. "This report has significant flaws in it."

Kliebert, however, said the report was thorough and provided useful information. She said her staff committed hundreds of hours to compiling the data, in a tight time frame that gave DHH seven months to pull the report together after the law's passage.

"It wasn't like you just found out when it was passed. I think y'all knew this thing was coming," Rep. Hunter Greene, R-Baton Rouge, said of the reporting requirements.

Jindal privatized much of the Medicaid program in 2012, shifting 900,000 of Louisiana's 1.4 million Medicaid recipients to the insurance model, mostly pregnant women and children. Medicaid recipients in Bayou Health choose from — or are assigned to — one of five privately operated networks of primary care doctors, specialists and hospitals.

The auditor's review said the DHH report used primarily self-reported data from the managed-care organizations. Kliebert said her department uses a verification process to check the information and has contracted with an outside accounting firm to do additional reviews.

Purpera also said the report asserted the state saved money from the privatization, but he said the health department didn't provide information to corroborate that.

"They can't say overall whether or not they're saving any money?" asked Rep. Cameron Henry, R-Metairie.

Kliebert said her agency has documentation to prove it saved nearly $136 million in the 2013 budget year. Only about $44 million of that figure was state general fund savings, however, while the rest was a reduction in federal Medicaid money.

Lawmakers said they wanted that data shared with the legislative auditor and more details about how the savings figure was reached.

"When you tell somebody you saved $100 million, you ought to be able to show where you saved it from," said Sen. Robert Adley, R-Benton.

"We can show you where we saved it from," Kliebert replied.

Kliebert said she expects to tweak and improve the Bayou Health report, based on legislative feedback.

"I think you'll be much happier with the report next year," she told lawmakers.

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