Health providers express concern over Medicaid Managed Care implementation

Medicaid Managed Care is achieving its goal of saving Kentucky money, but health providers continue to express concerns about the implementation. During an Interim Joint Committee Meeting on Health and Welfare, State Medicaid Commissioner Lawrence Kissner told legislators the Medicaid Managed Care system is $40 million under budget through October, saving approximately 2%.

However, there were many questions to the Commissioner regarding the oversight of the managed care companies by his Cabinet. Senate Health and Welfare Chairwoman Julie Denton stated there were significant concerns from hospitals, doctors and pharmacies indicating a number of overdue bills are not being paid and urged the Cabinet to resolve these problems. In response, Kissner stated two managed care companies are now under corrective action plans with the Department of Insurance for failing to pay claims. Rep. John Will Stacy, who owns pharmacies in eastern Kentucky, told the Commissioner if payments are not going to be made in a timely fashion, the number of providers will drop. 

Medicaid Managed Care is projected to save the state $1.3 billion in Medicaid costs. One company, Kentucky Spirit, announced it was going to break its contract because it was losing money and claimed the state gave incorrect information when they made their bid. Commissioner Kissner wouldn’t comment on this because it is an ongoing legal issue.