Health News
- Agreement Will Move At Least 600 From Personal-care Homes To Community Mental Health Facilities
At least 600 people now in personal-care homes will be moved to community-based settings under "an agreement that advocates say will systematically change the way community mental health services are delivered in Kentucky, improving the lives of hundreds...
- Rushed Transition To Managed Care Is Cautionary Tale For Other States, Especially Those With Large Rural Populations
Since Kentucky's abrupt change to a Medicaid managed-care system in 2011, problems have been widespread among patients and providers, highlighting the dangers for other states, and especially rural ones, about a rushed transition to this model without...
- Aetna Buying Coventry, Which Manages Some Medicaid Care
Aetna will buy Coventry Health Care for about $5.6 billion as the third-largest health insurance company poises itself for more Medicare and Medicaid patients under the federal health-care reform law. Coventry Cares is one of four managed care organizations...
- Cabinet For Health And Family Services Held In Contempt Over Medicaid Services For Eastern Kentuckians
Hazard Appalachian Regional Medical Center, one of eight ARH hospitals. Courier-Journal photo, copyright 2000For taking "practically no steps to a comply" to a request to help thousands of patients transfer their Medicaid services, the Cabinet for Health...
- Coventry Offers To Keep Paying Arh, But Less, For Treating Medicaid Patients; Asks Danville Chain To Renegotiate
Coventry Cares has offered to pay for treatments at Appalachian Regional Healthcare as a "non-contracted provider," which would mean ARH would be paid far less than it is now, but coverage for ARH's 25,000 Medicaid patient members would not be interrupted....
Health News
Daytime mental-health programs shrink, citing problems with managed-care Medicaid; pastoral counselors to be licensed
Access to daytime mental-health care "is on a steep decline in Kentucky, leaving what some fear is a gap in care that isolates the mentally ill at home or drives them out into the streets, hospitals or jail," Mike Wynn of The Courier-Journal's Frankfort Bureau reports. The Kentucky Association of Regional Programs, the lobby for community mental-health centers, "reports that 33 of the roughly 50 programs offered across the state have closed in the past 18 months while four others have reduced their hours by half," affecting an estimated 1,000 people.
The state Department for Behavioral Health, Developmental and Intellectual Disabilities says these community mental-health centers should embrace "a shift away from using day programs," Wynn writes, but mental-health advocates "say the centers have struggled to get enough coverage authorized under Kentucky's Medicaid managed-care system to keep the services operating. That has forced programs to close before new services are available to replace them, they argue."
The advocates say that among companies that manage care in Kentucky under Medicaid, Coventry Cares and its subsidiary MHNet "are by far the worst about denying coverage or reducing hours for therapeutic day programs. Coventry and MHNet are owned by insurance provider Aetna," which "says complaints are off target and that it is committed to providing patients with high-quality care. MHNet has approved two-thirds of the requests it received for therapeutic rehabilitation since January 2013, Aetna said in a statement."
Steve Shannon, executive director of the centers' lobbying group, "said that even mild reductions ? such as approving services for three days a week rather than five ? can wreak havoc on a program's financial viability," Wynn writes. "He also argues that centers may have stopped requesting services once they realized that MHNet would not approve them." (Read more)
Meanwhile, Kentucky has become the sixth state to license pastoral counselors under a new law that will also allow them to be paid for their services. The sponsor of Senate Bill 61, Sen. Alice Forgy Kerr of Lexington, told Jack Brammer of the Lexington Herald-Leader that the counselors must have a master of pastoral counseling degree, in addition to the same qualifications as other licensed counselors, and must also pass a written examination. (Read more)
The state Department for Behavioral Health, Developmental and Intellectual Disabilities says these community mental-health centers should embrace "a shift away from using day programs," Wynn writes, but mental-health advocates "say the centers have struggled to get enough coverage authorized under Kentucky's Medicaid managed-care system to keep the services operating. That has forced programs to close before new services are available to replace them, they argue."
The advocates say that among companies that manage care in Kentucky under Medicaid, Coventry Cares and its subsidiary MHNet "are by far the worst about denying coverage or reducing hours for therapeutic day programs. Coventry and MHNet are owned by insurance provider Aetna," which "says complaints are off target and that it is committed to providing patients with high-quality care. MHNet has approved two-thirds of the requests it received for therapeutic rehabilitation since January 2013, Aetna said in a statement."
Steve Shannon, executive director of the centers' lobbying group, "said that even mild reductions ? such as approving services for three days a week rather than five ? can wreak havoc on a program's financial viability," Wynn writes. "He also argues that centers may have stopped requesting services once they realized that MHNet would not approve them." (Read more)
Meanwhile, Kentucky has become the sixth state to license pastoral counselors under a new law that will also allow them to be paid for their services. The sponsor of Senate Bill 61, Sen. Alice Forgy Kerr of Lexington, told Jack Brammer of the Lexington Herald-Leader that the counselors must have a master of pastoral counseling degree, in addition to the same qualifications as other licensed counselors, and must also pass a written examination. (Read more)
- Agreement Will Move At Least 600 From Personal-care Homes To Community Mental Health Facilities
At least 600 people now in personal-care homes will be moved to community-based settings under "an agreement that advocates say will systematically change the way community mental health services are delivered in Kentucky, improving the lives of hundreds...
- Rushed Transition To Managed Care Is Cautionary Tale For Other States, Especially Those With Large Rural Populations
Since Kentucky's abrupt change to a Medicaid managed-care system in 2011, problems have been widespread among patients and providers, highlighting the dangers for other states, and especially rural ones, about a rushed transition to this model without...
- Aetna Buying Coventry, Which Manages Some Medicaid Care
Aetna will buy Coventry Health Care for about $5.6 billion as the third-largest health insurance company poises itself for more Medicare and Medicaid patients under the federal health-care reform law. Coventry Cares is one of four managed care organizations...
- Cabinet For Health And Family Services Held In Contempt Over Medicaid Services For Eastern Kentuckians
Hazard Appalachian Regional Medical Center, one of eight ARH hospitals. Courier-Journal photo, copyright 2000For taking "practically no steps to a comply" to a request to help thousands of patients transfer their Medicaid services, the Cabinet for Health...
- Coventry Offers To Keep Paying Arh, But Less, For Treating Medicaid Patients; Asks Danville Chain To Renegotiate
Coventry Cares has offered to pay for treatments at Appalachian Regional Healthcare as a "non-contracted provider," which would mean ARH would be paid far less than it is now, but coverage for ARH's 25,000 Medicaid patient members would not be interrupted....