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Wed February 20, 2013
Hospitals, Health Department Voice Concerns, but MCOs Say Groups Aren't Engaging With Them
Representatives of the state's health department and various hospital executives say almost two years later they are still having payment issues with Medicaid managed care organizations.
Speaking before a House budget subcommittee on health issues, the two groups described situations in which payment for care they administrated months ago were still outstanding claims.
Scott Lockard works in the Clark County Health Department and told lawmakers the state public health department was still owed more than $18 million in late payments. More than $14 million of that is with Kentucky Spirit, which is trying to break its contract and leave the system.
But he added that conversations about those payments are ongoing.
"Lots of us on the local level have been talking to our local reps for WellCare and Coventry as well, trying to get these issues resolved," Lockard said.
Numerous hospital representatives explained their issues with extra fees and late payments on needed care they are obligated to provide.
And while state health employees say they are working to resolve their claims, the hospital executives told House committee members they weren't having the same success.
But Michael Murphy, CEO of CoventryCare of Kentucky, says his organization has worked diligently to resolve issues and that any remaining ones are a result of people not coming to the table to talk.
"If you're gonna sit and complain and not engaged us and talk to us about what's going on, we don't have time to mess with it cause there's no time to get that done and certainly no one's gonna benefit from it," Murphy said.
He added that Coventry has lost more than $100 million since it started work in Kentucky in November 2011 and expected not to make a profit for years to come.
House lawmakers expressed interested in hearing solutions to the issues brought before them besides returning to the old fee for service model, which chairman Jimmie Lee said wasn't going to occur.