Health News
- Kentucky Spirit Can't Terminate Its Medicaid Contract With The State A Year Early Without Facing Fines, Judge Rules
By Molly Burchett Kentucky Health News A Frankfort circuit judge ruled Friday that Kentucky Spirit, one of three companies hired by the state in November 2011 to manage health care for more than 540,000 Medicaid recipients, cannot pull out of its contract...
- Coventry, Arh At Impasse Over Medicaid; State Says Service Will Not Be Interrupted For 25,000 Affected
Though negotiations between Appalachian Regional Healthcare and Coventry Cares appear to be futile, the state is taking steps to make sure there won't be an interruption in care for the Medicaid recipients who will be affected by the impasse....
- Managed-care Firm Coventry Threatens To Terminate Contracts Of Baptist Healthcare And Big Ashland Hospital
Lexington Herald-Leader photo by Charles BertramIssues with the state's managed-care companies continue to mount. Now Coventry Cares has told Baptist Healthcare System, which has hospitals in Lexington, Louisville, La Grange, Paducah and Corbin,...
- Appalachian Hospital Chain, Facing Loss Of 25,000 Medicaid Patients, Sues Managed-care Firms And State
"Appalachian Regional Healthcare, the largest health care system in Eastern Kentucky, has filed lawsuits against two of the state's Medicaid managed care companies, alleging that the managed care companies had not paid claims promptly," report Valarie...
- Managed-care Executives Acknowledge Problems, Say They're Trying To Fix Them
Executives of three managed-care companies who run most of the state's Medicaid program told a legislative committee yesterday that they are aware of "significant problems" with their management since they took over in November, and they are "committed...
Health News
Home-health industry is the latest to complain about late payments since state switched to managed-care Medicaid
Kentucky's new Medicaid managed-care system is three months late in making payments to home-health agencies, officials told the House Health and Welfare Committee Thursday.
Nurses Registry and Home Health has outstanding claims of $300,000 to $400,000, Jeannie Lemaster, chief compliance officer, told lawmakers. "Kip Bowmar, executive director of the Kentucky Home Health Association, said only 8 percent of the claims from the approximately 150 home-health agencies have been paid since the switch to managed care Nov. 1," reports Beth Musgrave of the Lexington Herald-Leader.
"If these problems don't get corrected, there is a likelihood that some agencies could go out of business," Bowmar said.
Therapists who work with abused, neglected and at-risk children have likewise told lawmakers of back payments. Independent pharmacists have said "reimbursement rates are much lower than they were under traditional Medicaid, which means they are having to lay off employees," Musgrave reports.
In November, Kentucky made the switch to managed care for its 500,000 Medicaid recipients outside the Louisville region. The move is expected to save the state more than $1 billion in the next three years. Three companies, Coventry Cares, Wellcare of Kentucky and Kentucky Spirit, broker the care and are paid on a per-patient, per-month rate.
Lemaster said most of her agency's problems are with Coventry, which has denied 82 percent of their claims. "Lemaster said that because there are differences in the managed care companies and what is being approved for payments, there are inequities in the Medicaid system," Musgrave reports. "Some people are receiving services and others aren't."
Jill Midkiff, spokeswoman for the Cabinet for Health and Family Services, said problems related to the changeover are being ironed out. "The primary focus of the Medicaid program staff is and continues to be the prompt resolution of any issues that arise as we ease the transition of providers to managed care," she said. (Read more)
- Kentucky Spirit Can't Terminate Its Medicaid Contract With The State A Year Early Without Facing Fines, Judge Rules
By Molly Burchett Kentucky Health News A Frankfort circuit judge ruled Friday that Kentucky Spirit, one of three companies hired by the state in November 2011 to manage health care for more than 540,000 Medicaid recipients, cannot pull out of its contract...
- Coventry, Arh At Impasse Over Medicaid; State Says Service Will Not Be Interrupted For 25,000 Affected
Though negotiations between Appalachian Regional Healthcare and Coventry Cares appear to be futile, the state is taking steps to make sure there won't be an interruption in care for the Medicaid recipients who will be affected by the impasse....
- Managed-care Firm Coventry Threatens To Terminate Contracts Of Baptist Healthcare And Big Ashland Hospital
Lexington Herald-Leader photo by Charles BertramIssues with the state's managed-care companies continue to mount. Now Coventry Cares has told Baptist Healthcare System, which has hospitals in Lexington, Louisville, La Grange, Paducah and Corbin,...
- Appalachian Hospital Chain, Facing Loss Of 25,000 Medicaid Patients, Sues Managed-care Firms And State
"Appalachian Regional Healthcare, the largest health care system in Eastern Kentucky, has filed lawsuits against two of the state's Medicaid managed care companies, alleging that the managed care companies had not paid claims promptly," report Valarie...
- Managed-care Executives Acknowledge Problems, Say They're Trying To Fix Them
Executives of three managed-care companies who run most of the state's Medicaid program told a legislative committee yesterday that they are aware of "significant problems" with their management since they took over in November, and they are "committed...