Medicaid Managed Care

12:24 pm
Thu July 5, 2012

Republican Leader Calls On Beshear to Opt Out of Medicaid Expansion

The highest-ranking Republican in the Kentucky state House is calling on Governor Steve Beshear to reject an expansion of Medicaid set forth in the Affordable Care Act.

The Supreme Court ruling on the healthcare law allows states to opt out of the expansion of the program. House Minority Floor Leader Jeff Hoover wants Beshear to follow other states that have opted out.

Hoover says expanding the program in Kentucky would put an even bigger burden on the state budget, even with managed care operators running the system.

Read more
6:15 pm
Wed June 27, 2012

New Medicaid Commissioner Named

After two years of interim leadership, the Cabinet for Health and Family Services has a permanent Medicaid Commissioner. 

Lawrence Kissner is the current CEO of Magnolia Health Plan, a managed care operator in Mississippi. He will start as Kentucky's new Medicaid commissioner July 1. 

The move continues the overhaul Secretary Audrey Haynes began when she took her job in April. 

Read more
3:57 pm
Sat June 23, 2012

Mixed Results for Medicaid Operators in Kentucky

Reporter Kenny Colston

Last year, Kentucky state officials approved plans to bring on more regional Managed Care Operators, MCOs, to administer the state’s Medicaid program, which has been facing significant budget shortfalls.

Read more
3:30 pm
Thu June 21, 2012

Kentucky Seeking Private Medicaid Operators for Louisville Region

The process of opening the Louisville area to Medicaid competition is underway.

Passport Health Plan has run Medicaid in the area for 15 years, but the state has been ordered by the federal government to allow at least one more private operator to do business in the region.

Passport officials say they will bid for the contract and requests were sent to other potential bidders this week.

Read more
5:07 pm
Wed June 20, 2012

CoventryCares Lost $50 Million In First Quarter, CEO Blames State Government


The CEO of Kentucky’s largest private Medicaid operator says massive financial losses and bad data are to blame for the problems with managed cared in Kentucky.

For weeks, CoventryCares has sought to terminate or revise its contracts with more than a dozen healthcare providers so the company would pay lower reimbursement rates when doctors treat Medicaid patients. And in a meeting before the interim joint Health and Welfare Committee today, CEO Michael Murphy said his company's actions were motivated by losses. 

Read more
4:25 pm
Tue June 19, 2012

Lawmakers Plan to Question Coventry CEO Over Contract Issues

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.  

Read more
8:30 am
Mon June 18, 2012

Medicaid Regulations No Match for Rural Roads

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.

Read more
4:38 pm
Mon June 11, 2012

Disputes Between ARH and Coventry Leads to Confusion for Patients

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.

Read more
6:31 am
Tue May 29, 2012

Edelen Says He'll Audit Private Medicaid Operators This Year


After months of mounting problems, State Auditor Adam Edelen says he will launch a full investigation intoKentucky’s statewide Medicaid Managed Care system.

Edelen created a Medicaid task force in February after taking a first look at the managed care system. He also gave recommendations to managed care companies, health care providers and the state on how to make the system run better in the future.

But with clashes between private Medicaid companies and healthcare providers ongoiong, Edelen wants to take a stronger look into the system.

Read more
2:26 pm
Mon May 14, 2012

Outside Medicaid Managed Care Company Attempting to Gain Foothold in Louisville

State officials have not yet given private Medicaid operators permission to do business in the Louisville area, but that hasn’t stopped one company from trying to make inroads.

Read more