cross-posted from: https://lemm.ee/post/59903645
I will put references for all of this info in a comment to save space:
So back in Feb Landry announced he found $11M in savings from Louisiana Department of Health (LDH).
It turns out that a few weeks before that, Louisiana DOGE held secret meetings with Tara LeBlanc, an employee who works for Guidehouse, a consulting firm in the DC area. Before she worked for Guidehouse, she was director of Medicaid at LDH. Since these meetings were held in secret, there is no public record and we don't know what they actually discussed (which is a violation of transparency law).
1 week after Landry said he found $11M in savings, he announces LA DOGE was partnering with the LA Legislative auditor to find savings.
A little under two weeks after that, the LA Legislative auditor releases a report saying that LDH is being audited for misspending funds for Medicaid program MCIP, which was designed to enhance health outcomes for patients on Medicaid. The program was created in 2018 and implemented in 2019.
The audit is blaming the hospitals that were running the programs. However, think back to that secret meeting for a second: A Guidehouse description of Tera Leblanc welcomes the former Medicaid Executive Director for the LA Department of Health, and says she previously "designed and implemented plans to elevate Louisiana’s pioneering public health emergency unwinding strategy and enhance outcomes for Medicaid beneficiaries."
Tera LeBlanc was deputy and then executive director of Medicaid from (2019-2023). This means that LeBlanc was involved in designing and implementing plans to improve outcomes for Medicaid beneficiaries during 4 of the 5 years (2019-2024) that the Louisiana Legislative Auditor claims MCIP funds were misspent on administrative costs such as submitting reports and meetings.
Why do I bring up your LCMC doctors?
Around the time this audit was announced, I learned that several doctors who accept Medicaid were suddenly no longer with LCMC. Nobody seems to understand exactly what is going on. Nurses trying direct people on where to find care are being informed by patients that doctors they are recommending patients contact are no longer with LCMC. There is no reporting on this, which is why I am asking people to help me figure out exactly how widespread this issue is.
According to Landry's team, they found $11M in savings at LDH by eliminating contracts and almost 60 of the health department’s 7,700 employment positions in an effort to reduce spending. I would really like to see exactly what contracts and positions those were.
However, Landry's team also says the overall LDH budget for next year is also increasing due to Medicaid costs being out of their control. This is all apparently coming from federal money, but the day after an article came out clarifying that LDH budget was increasing by $1.5B, another article came out that said the Federal DOGE was suddenly slashing $55M in grant money already given to LDH. Some grants had already expired, but others hadn't.
The most recent estimate of budget elimination when considering expired vs not expired grants is ~$10M. Now LDH is having to figure out how to make up for that $10M in other ways. Which seems like it kind of offsets any "$11M savings" Landry found, but honestly I am very confused by most of this.
I do know that the LA Surgeon General Ralph Abraham, who has long opposed Medicaid expansion, claims that one reason the Medicaid budget is growing is because they have to offer doctors more money as an incentive to get them to accept Medicaid.
You've probably heard the often repeated phrase "no doctors want to accept Medicaid patients." So why were several doctors that accept Medicaid patients abruptly no longer practicing at LCMC?
Seems kind of counter intuitive to claim you need more money to pay doctors to incentivise them, only to have one of your largest contractors suddenly no longer employ doctors who have been accepting Medicaid patients for years, right?
If you get rid of all the doctors that will accept Medicaid, then it becomes pretty easy to prove the point that no doctors want to accept patients on Medicaid. Weird.