WHEREAS, the state of Louisiana currently offers health benefits to employees, retirees, and dependents of state agencies, school boards, and various political subdivisions through the Office of Group Benefits (hereafter "OGB");
WHEREAS, in excess of two hundred twenty thousand (220,000) state, school board, and political subdivision employees, retirees, and their dependents currently receive health benefits through OGB;
WHEREAS, OGB is projecting a FY 2003 operating budget in excess of $800 million;
WHEREAS, health care and pharmaceutical costs are increasing at double-digit rates across the nation and are projected to do so into the future;
WHEREAS, the current options and rate structures offered by OGB face rising costs similar to other plans across the nation;
WHEREAS, providers have expressed dissatisfaction with the claims processing, reimbursement rates and reimbursement methodology;
WHEREAS, the well-being of the state government workforce is vital to the proper functioning of state government and to the people of the state;
WHEREAS, it is essential to the well-being of the state government workforce that its employees have access to the best possible health care services at the lowest possible rates;
WHEREAS, Executive Order No. MJF 2000-46, issued on November 16, 2000, created the State Employees Group Benefits Program Study Commission (hereafter "SEGBPSC")
WHEREAS, recommendations of the SEGBPSC were implemented by Act No. 1178 of the 2001 Regular Session of the Louisiana Legislature;
WHEREAS, SEGBPSC also recommended that a subsequent study commission be established to address issues not included within its recommendations, such as long range planning; and
WHEREAS, the interests of the state of Louisiana and its employees can best be served by the creation of a new commission to study the best way to provide high quality health benefits to state employees at the lowest price possible;
NOW THEREFORE, I, M.J. "MIKE" FOSTER, JR., Governor of the state of Louisiana, by virtue of the authority vested by the Constitution and laws of the state of Louisiana, do hereby order and direct as follows:
SECTION 1: The Office of Group Benefits Study Commission (hereafter "Commission) is established within the executive department, Office of the Governor.
SECTION 2: The duties and functions of the Commission shall include, but are not limited to, the following:
A. Conducting an Internal Operational Assessment to review, analyze, and benchmark health options and rate structures offered through OGB;
B. Identifying and evaluating best practice options to improve the efficiency and cost effective administration of OGB, including internal administration, staffing models, outsourcing, and privatization;
C. Identifying and evaluating best practice options for the most cost effective and efficient delivery of pharmaceutical benefits, including proactive pharmacy benefits management;
D. Analyzing the future impact of providing health benefits on the state budget; the requirements of the Federal Health Insurance Portability and Accountability Act of 1996; and the proposed Patients Bill of Rights legislation;
E. Examining and evaluating the existing provider reimbursement methodology and reimbursement rates, timeliness of payments, and making recommendations for improvements;
F. Exploring competitive medical management systems, including recommending and/or piloting innovative health benefits options;
G. Exploring a Medicare buy-in for those employees and retirees not covered; and
H. Conducting public hearings to receive input from Group Benefits plan members, stakeholders, and others who are affected by OGB.
SECTION 3: The Commission shall submit a comprehensive written report to the governor by December 5, 2002, which addresses the issues set forth in Section 2 of this Order.
SECTION 4: With the exception of the members of the Louisiana Legislature, all members of the Commission shall be appointed by the governor. With the exception of the legislative and executive members, all members shall serve at the governor's pleasure. The Commission shall be composed of eighteen (18) members selected as follows:
B. Three (3) members of the Senate, appointed by the president of the Senate, including the chair of the Senate Committee on Finance;
C. Three (3) members of the House of Representatives, appointed by the speaker of the House of Representatives, including the chair of the House Committee on Appropriations.
D. The secretary of the Department of Health and Hospitals, or the secretary=s designee;
E. The superintendent of the Department of Education, or the superintendent=s designee;
F. The CEO of Louisiana State University Health Science Center, or the CEO=s designee;
G. The chair of the Office of Group Benefits Planning and Policy Board, or the chair=s designee;
H. One (1) member who is employed by the Department of Insurance with expertise in health insurance matters;
I. One (1) member of the Louisiana Hospital Association;
J. One (1) member who represents active state employees;
K. One (1) member who represents retired state employees;
L. One (1) member who is employed by an institution of higher education with expertise in the field of health care services;
M. One (1) member who represents the business insurance industry; and
N. One (1) member with expertise in the delivery of medical care services.
SECTION 5: The governor shall appoint the chair of the Commission. All other officers, if any, shall be elected by the membership of the Commission.
SECTION 6: The Commission shall meet at regularly scheduled intervals and at the call of the chair.
SECTION 7: Support staff, facilities, and resources for the Commission shall be provided by the Office of Group Benefits.
SECTION 8: All departments, commissions, boards, agencies, and officers of the state, or any political subdivision thereof, are authorized and directed to cooperate with the Commission in implementing the provisions of this Order.
SECTION 9: This Order is effective upon signature and shall continue in effect until amended, modified, terminated, or rescinded by the governor, or terminated by operation of law.
M.J. "Mike" Foster, Jr.
Secretary of State