AI-assisted research summary: Covered state health care delivery systems and certain basic benefits plans must include essential community providers, and the Louisiana Department of Health must issue rules setting minimum participation levels.
§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. Acts 1995, No. 1282, §1, eff. June 29, 1995.