(Louisiana, LA – Insurance News 360) – On Sept. 1, Louisiana Insurance Commissioner Jim Donelon took control of the Louisiana Health Cooperative (CO-OP), following the issuance of an Order of Rehabilitation and Injunctive Relief by the 19th Judicial District Court. The CO-OP is a health maintenance organization (HMO) that had announced it would wind not offer coverage in 2016.
“Our on-site review and analysis of the Louisiana Health Cooperative’s operations led us to the decision that placing it in Rehabilitation is in the best interests of its policyholders and providers, as well as taxpayers,” said Commissioner Donelon. “We are convinced that the CO-OP, with the support of the Centers for Medicare and Medicaid Services (CMS), will have the ability to pay claims owed to health care providers and I am confident that we can more efficiently and successfully wind down affairs in a timely and equitable fashion.”
The CO-OP was placed into rehabilitation when the Louisiana Department of Insurance determined it would be best for policyholders, doctors and taxpayers for the CO-OP to wind down. CO-OP policies are effective through the end of the year and the order of rehabilitation will allow uninterrupted healthcare for policyholders and payments to providers. Policyholders will need to enroll in new coverage for January 2016 during the open enrollment period (Nov. 1 2015 to January 31, 2016). For a policy to take effect Jan. 1, policyholders must be enrolled by Dec. 15, 2015.
The Louisiana Department of Insurance will work with healthcare providers to ensure that payment is issued in a timely manner.
Additional information can be found on the LDI website at www.ldi.la.gov/LAHC. Inquiries may be directed to LAHC@ldi.la.gov or to the Louisiana Department of Insurance Office of Consumer Services at 1-800-259-5300 or 225-342-5900.
Source: Louisiana Department of Insurance.