Rights and Responsibilities

Member Rights

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.

Member Responsibilities

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.