Health News
- Medicaid Managed-care Firms Get New Contracts With New Rules Aimed At Resolving Health-care Providers' Issues With Program
Kentucky has signed new contracts with five managed-care firms that will manage Medicaid coverage for more than 1.1 million Kentuckians. Contracts were awarded to Anthem, Coventry Cares, Humana, Passport and Wellcare. Kentucky changed Medicaid to managed...
- Haynes Asks Hospitals For A Truce As They And State Work Through Problems With Managed-care Medicaid
Health and Family Services Secretary Audrey Haynes won a smattering of applause from Kentucky hospital officials Thursday as she called for "not a surrender, but a truce" as her cabinet continues to address the hospitals' complaints about the state's...
- Beshear Says His Managed-care Plan Is Saving Money And Improving Health Outcomes; State Points Finger At Hospitals
Six months ago, Gov. Steve Beshear applied an intensive plan to solve Medicaid managed-care implementation issues. On Thursday, he said the system is working more effectively for both providers and managed care organizations. He also said hospitals'...
- House Sends Senate Pill-mill And Medicaid Managed-care Fixes
The state House yesterday approved without dissent two bills aimed at improving Kentucky's health care. House Bill 217 addresses some "unintended consequences" of last year's "pill mill bill" by easing some of the bills regualtions....
- Bill To Make Medicaid Managed-care Firms Pay Up, And More Promptly, Nears Final Form In House And Will Get Attention In Senate
By Molly Burchett and Al Cross Kentucky Health News The complaints by many health-care providers about Medicare managed-care firms' delay or denial of payment claims appears to be generating a bipartisan solution in the General Assembly. A bill on...
Health News
Beshear vetoes prompt-pay bill but takes several steps to address problems in Medicaid; he and Haynes say it's working
Gov. Steve Beshear has vetoed the bill designed to make Medicaid managed-care firms pay health-care providers more quickly, but is taking administrative steps to address the issue.
Beshear said he agreed with the intent of House Bill 5 but it might have interfered with the contractual relationship between the state and the four managed-care companies. The bill would have subjected that relationship to the state Department of Insurance's review and investigation process for private-insurance payment complaints.
Beshear said he agreed with the intent of House Bill 5 but it might have interfered with the contractual relationship between the state and the four managed-care companies. The bill would have subjected that relationship to the state Department of Insurance's review and investigation process for private-insurance payment complaints.
"That language would have resulted in excessive costs for state government and taxpayers due to the expansion of the review process beyond the current parameters used for private insurance," Beshear's office said in a press release.
Instead, Beshear ordered the department to take over responsibility for review of prompt-payment complaints from the Department for Medicaid Services. "If improper payment practices are discovered, DOI can impose sanctions," the release said. He also ordered the department to audit each of the managed-care firms operating statewide ? Wellcare,Coventry Cares , and Kentucky Spirit ? at their cost.
Meanwhile, the firms have agreed to meet with every hospital they have under contract to reconcile outstanding accounts. "This effort will begin immediately and continue until every hospital?s accounts receivable has been reconciled," the release said. "The results will . . . be made public, in order to provide transparency and accountability." The firms have agreed to meet with any other provider who wants a meeting.
Instead, Beshear ordered the department to take over responsibility for review of prompt-payment complaints from the Department for Medicaid Services. "If improper payment practices are discovered, DOI can impose sanctions," the release said. He also ordered the department to audit each of the managed-care firms operating statewide ? Wellcare,
Meanwhile, the firms have agreed to meet with every hospital they have under contract to reconcile outstanding accounts. "This effort will begin immediately and continue until every hospital?s accounts receivable has been reconciled," the release said. "The results will . . . be made public, in order to provide transparency and accountability." The firms have agreed to meet with any other provider who wants a meeting.
Also, the Cabinet for Health and Family Services will hold eight regional forums for providers, managed-care firms, and Insurance Department representatives to discuss concerns and how to improve the system. Part of this effort will focus on "emergency room management that meets community needs without an ER operating as a de facto primary-care office," the release said. "A key component of controlling costs and improving health in a healthcare system is to provide the right treatment in the most cost-effective setting."
CHFS Secretary Audrey Tayse Haynes said the switch to managed care, made in November 2011, is working. ?We are already seeing a tremendous increase in the use of preventive services, which improve health-care outcomes, while also reducing the enormous costs for treating chronic health conditions? such as diabetes-related amputations, she said.
Beshear said his plan would solve "lingering implementation problems" with managed care "while preserving the significant improvements in patient care and health care cost savings."
CHFS Secretary Audrey Tayse Haynes said the switch to managed care, made in November 2011, is working. ?We are already seeing a tremendous increase in the use of preventive services, which improve health-care outcomes, while also reducing the enormous costs for treating chronic health conditions? such as diabetes-related amputations, she said.
Beshear said his plan would solve "lingering implementation problems" with managed care "while preserving the significant improvements in patient care and health care cost savings."
"Getting our people healthy and keeping them that way is not just good health policy, it?s good economics," Beshear said. "That?s why we will never return to the old fee-for-service system. This is a significant cultural shift in medical care that has already happened across the country in both the private insurance market and in the Medicaid system."
- Medicaid Managed-care Firms Get New Contracts With New Rules Aimed At Resolving Health-care Providers' Issues With Program
Kentucky has signed new contracts with five managed-care firms that will manage Medicaid coverage for more than 1.1 million Kentuckians. Contracts were awarded to Anthem, Coventry Cares, Humana, Passport and Wellcare. Kentucky changed Medicaid to managed...
- Haynes Asks Hospitals For A Truce As They And State Work Through Problems With Managed-care Medicaid
Health and Family Services Secretary Audrey Haynes won a smattering of applause from Kentucky hospital officials Thursday as she called for "not a surrender, but a truce" as her cabinet continues to address the hospitals' complaints about the state's...
- Beshear Says His Managed-care Plan Is Saving Money And Improving Health Outcomes; State Points Finger At Hospitals
Six months ago, Gov. Steve Beshear applied an intensive plan to solve Medicaid managed-care implementation issues. On Thursday, he said the system is working more effectively for both providers and managed care organizations. He also said hospitals'...
- House Sends Senate Pill-mill And Medicaid Managed-care Fixes
The state House yesterday approved without dissent two bills aimed at improving Kentucky's health care. House Bill 217 addresses some "unintended consequences" of last year's "pill mill bill" by easing some of the bills regualtions....
- Bill To Make Medicaid Managed-care Firms Pay Up, And More Promptly, Nears Final Form In House And Will Get Attention In Senate
By Molly Burchett and Al Cross Kentucky Health News The complaints by many health-care providers about Medicare managed-care firms' delay or denial of payment claims appears to be generating a bipartisan solution in the General Assembly. A bill on...