Tagged: Medicaid Managed Care

A bill  moving Medicaid late payment claims to the Department of Insurance appears to have some support in the state Senate.

House Bill 5 would take prompt pay issues with the Medicaid managed care system and put it through the Insurance Department's current claims process. Currently, the Cabinet for Health and Family Services deal with late claims.

Sen. Julie Denton, chair of the Senate Health and Welfare Committee, said she plans to give the bill a hearing and supports the bill's attempts to make managed care organizations pay providers.

House Speaker Greg Stumbo's bill that would transfer late payments claims in Medicaid managed care has cleared its first committee.

The legislation moves dealing with late payment issues between health care providers and managed care organizations to the Department of Insurance's third party system. Currently, the Cabinet for Health and Family Services deals with those issues—but how those issues are dealt with has become a major issue in Kentucky's managed care system.

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.

A bill requiring Kentucky Medicaid managed care operators publish a list of prescriptions and reimbursement prices on Wednesday passed a state Senate committee, following prodding from  independent pharmacists asking for access to pricing standards before they fill prescriptions.

The group of independent pharmacists told lawmakers that they are still having trouble with reimbursements from the state's Medicaid managed care operators. And they said they were also still being dramatically undercut on prescription reimbursements when they did receive them.

The Speaker of the Kentucky House says it’s a no-brainer for Kentucky to expand its Medicaid program under the Affordable Care Act. 

Under the health care law, states can expanded their Medicaid rolls to 138 percent of the poverty line and for three years, the federal government will pay for the expansion.

Kentucky Governor Steve Beshear has yet to decide on whether Kentucky will expand, saying he will calculating costs after 2017, when the feds pay only 90 percent of expansion.