Rights and Responsibilities
As a member, you have certain rights. Louisiana Healthcare Connections also expects its providers to respect and honor your rights:
- To be treated with respect and dignity.
- To receive the right to privacy and non-discrimination as required by law.
- To join your providers in making decisions about your health care.
- To refuse any medical service, diagnoses, treatment or health service if you or your parent/guardian objects based on religious or other grounds.
- To discuss treatment options, regardless of cost or benefit coverage.
- To seek a second opinion.
- To receive information about Louisiana Healthcare Connections, including:
- Structure and operations
- Services and service utilization plans
- Practitioners and providers
- Physician incentive plans
- Member rights and responsibilities
- To make recommendations regarding Louisiana Healthcare Connections member rights and responsibilities.
- To get information about available experimental treatments and clinical trials and how such research may be accessed.
- To obtain assistance with care coordination from your provider(s).
- To be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation.
- To express a concern about or Appeal a Louisiana Healthcare Connections decision or the care it provides and to get a response in a reasonable period of time.
- To look at and get a copy of your medical records as permitted by law (one copy free of charge each year) and request they be amended or corrected.
- To make an Advance Directive.
- To file any complaint about not following your Advance Directive with LDH.
- To choose a provider who gives you care whenever possible and appropriate.
- To receive accessible health care services comparable in amount, duration and scope to those provided under Medicaid fee-for-service and sufficient in amount, duration and scope to be reasonably expected to achieve the purpose for which the services are furnished.
- To receive appropriate services not denied or reduced solely because of diagnosis, type of illness or medical condition.
- Freedom to exercise the rights described herein without any adverse effect on the your treatment by LDH, Louisiana Healthcare Connections, its providers or contractors.
- To receive all written member information from Louisiana Healthcare Connections:
- At no cost to you.
- In the prevalent non-English languages of its members in the service area.
- In other ways, to help with the special needs of members who may have trouble reading the information for any reason.
- To receive oral interpretation services free of charge for all non-English languages, not just those identified as “prevalent.”
- To be notified that oral interpretation services are available and how to access them.
- To get help from both LDH and its Enrollment Broker in understanding the requirements and benefits of Louisiana Healthcare Connections.
As a member, you have certain responsibilities:
- To inform Louisiana Healthcare Connections of the loss or theft of your Member ID card.
- To present your Member ID card when using health care services.
- To be familiar with Louisiana Healthcare Connections procedures to the best of your abilities.
- To call or contact Louisiana Healthcare Connections to obtain information and have questions clarified.
- To provide in-network providers with accurate and complete medical information.
- To follow prescribed treatment of care recommended by a provider or letting them know the reason(s) treatment cannot be followed, as soon as possible.
- To make every effort to keep scheduled appointments and follow-up appointments and access preventive care services.
- To live a healthy lifestyle and avoid behaviors known to be bad for your health.
- To provide accurate and complete information to all health care providers.
- To become knowledgeable about Louisiana Healthcare Connections’ coverage provisions, rules and restrictions.
- To ask questions of your providers to determine the potential risks, benefits, and costs of treatment alternatives and make care decisions after weighing all factors.
- To understand your health problems and participate in developing mutually agreed upon treatment goals with your provider to the highest degree possible.
- To follow the Grievance process established by Louisiana Healthcare Connections (and as outlined in the Member Handbook) if there is a disagreement with a provider.