Rights & Responsibilities

Welcome

Getting mental health services is private. We respect your right to privacy. You have, at the very least, the rights and responsibilities listed below.

Your Rights

If you receive services through Magellan, you have the right to:

  • Be treated with respect and consideration for your dignity and privacy.
  • Be treated fairly regardless of race, religion, gender, ethnicity, disability or source of payment.
  • Have your treatment and other information kept private. Records may be released without your permission only where permitted by law.
  • Easily get care in a timely fashion.
  • Receive information on available treatment options and alternatives in a way that is appropriate to your condition and easy to understand.
  • Share in developing your plan of care.
  • Receive interpretation services at no cost to you. You also have the right to receive information in a language that you can understand. Information is available in other formats if you request it.
  • Receive information about Magellan, its practitioners, programs, services, and role in the treatment process.
  • Receive information about the clinical guidelines used in providing and managing your care.
  • Ask providers about their work history and training.
  • Not be restrained or secluded to make you do something you do not want to do (as specified in federal regulations on the use of restraints and seclusion).
  • Give input on Magellan’s Rights and Responsibilities policy.
  • Request certain preferences in a provider.
  • Have provider decisions about your care made on the basis of treatment needs.
  • Be given health care services that obey state and federal laws that have to do with your rights.
  • Participate in decisions regarding your health care. This includes the right to receive a second medical opinion and the right to refuse treatment (except when ordered by a court).
  • File a grievance about Magellan, a provider or the care you receive.
  • File an appeal about a Magellan action or decision. You also have the right to request a State Fair Hearing if you are not satisfied with the result of the appeal.
  • Request and receive a copy of your medical records. You can also request that they be changed or corrected.
  • Exercise your rights. If you do this it will not affect the way Magellan and its providers treat you.
  • Receive written information on advanced directives and your rights under state law.
  • Have candid discussions with your provider about appropriate or medically necessary treatment options for your condition regardless of cost or benefit coverage.

Your Right to Information

You have the right to get information at any time from Magellan.  This includes, but is not limited to:

  • A Member Handbook at least once a year from Magellan as requested by you.
  • Information about providers.
  • Your rights and protections.
  • Written information on advance directives and your rights under state law.
  • A description of after-hours and emergency coverage, and how to get these services.
  • A description of emergency medical conditions.
  • A description of “post-stabilization” services:
    • The amount and type of your benefits.
    • The process for getting services. This includes getting approvals.
    • How to get a ride to services.
    • Grievance, appeal and fair hearing procedures. This includes their time frames.

This is just some of the information you can get from Magellan. Additional information is on our Magellan of Louisiana website.  For help with this information, please contact us at:

1-800-424-4489 or or if you are deaf or hard-of-hearing, call 7-1-1 to use the Louisiana Relay Service.

Your Responsibilities

Service recipients also have responsibilities with Magellan.  Accepting these responsibilities supports your recovery and helps you get the most benefit from your mental health services. It also helps us work with you better. You have the responsibility to:

  • Know and understand your provider’s procedures to the best of your ability.
  • Treat anyone giving you care with respect.
  • Call your provider if you have any questions.
  • Give information needed for your care to your providers.
  • Follow instructions and guidelines from your providers.
  • Ask questions of your providers and let your providers know if you can’t follow the treatment that was prescribed.
  • Know the name of your provider or case manager.
  • Call your Healthy Louisiana plan provider if you lose your Medicaid ID card.  If you are not sure to which plan you belong, call 1-855-BAYOU4U (1-855-229-6848) for assistance.
  • Keep any agreed upon appointment and follow-up appointment.
  • Tell your providers and primary care doctor about changes in your medicine.
  • Tell providers if you have to cancel a visit. Do this before the scheduled time.
  • If you don’t agree with a provider or Magellan, follow the grievance and appeals process described in this handbook.
  • Live a healthy life style.  Avoid behaviors that are not good for your health.
  • Report Fraud, Waste, and Abuse. You can report this to the Corporate Compliance Hotline 24 hours a day, seven days a week. This hotline is run by an outside company. You do not have to give your name when you call. All calls will be looked into and will stay private. You can report fraud, waste and abuse using one of the following methods:
    • Corporate Compliance Hotline: (800) 915-2108
    • Email Corporate Compliance 

You can also contact Magellan’s Special Investigations Unit hotline by:

  • Phone: 1-800-755-0850 or
  • Email SIU

You may also report directly to:

Provider Fraud
Gainwell, Inc.
SURS Department
8591 United Plaza Blvd
Baton Rouge, LA 70809

Recipient Fraud
Louisiana Department of Health
Customer Service Unit
P.O. Box 91278
Baton Rouge, LA 70821-9278

 

Website:  http://ldh.la.gov/index.cfm/page/219