Tagged: Coventry Cares

The departure of one of three statewide Medicaid operators next year is once again raising concerns about adequate medical coverage in parts of the state.

Kentuckians on Medicaid now have the opportunity to change healthcare providers for the first time in months.

Open enrollment for all of the state except Louisville started today. It's the first time since Medicaid was privatized that residents can choose a new private operator to handle their care.

KentuckyOne Health, the largest health system in the state, has dropped all contracts with Medicaid managed care organization Coventry Cares.

Coventry Cares had terminated two of its contracts with KentuckyOne Health, including one with Our Lady of Peace, which provides specialized services for high risk patients in Louisville.   Now, KentuckyOne spokesperson Barbara Mackovic  says her organization is responding by halting all its contracts with the managed care organization.

Kentucky lawmakers will get their first chance tomorrow to ask a private Medicaid operator why it’s having so much trouble negotiating contracts with healthcare providers.

The CEO of CoventryCares will speak to lawmakers at a meeting of the Interim Joint Health and Welfare Committee. Coventry has been fighting with the Eastern Kentucky hospital network Appalachian Regional Healthcare over reimbursement rates and a new contract.  

The dispute between an Eastern Kentucky hospital chain and private Medicaid operators has lawyers arguing distance versus drive time.

Under state regulations, a private Medicaid operator cannot sign up a patient unless it has a doctor or hospital within 60 miles of that patient's home. But that distance is measured as the crow flies and the state doesn't take into account narrow and winding Appalachian roads. For many patients, it may be faster to visit a doctor that's 70 miles away than it is to visit one that's 50 miles away.

A continued contract dispute between an Eastern Kentucky hospital network and the largest private Medicaid operator in the state is leading to confusion in the region.

CoventryCares and Appalachian Region Healthcare are locked in a legal dispute over a new contract, with another court hearing scheduled for tomorrow.