Health News
- Lawmakers Hear More Complaints About Managed Care
Patients with mental illness are being denied medication, forced to try cheaper drugs that have already been proven not to work for the patient, or not getting them in time because of delays in approval. These were some of the complaints of the state's...
- Legislators Hear From New Managed-care Firms; Lawmaker Rates Their Performance With A Show Of Hands From Pharmacists
Kentucky Health News The three companies recently hired to manage Kentucky's Medicaid program outside the Louisville region defended themselves yesterday against complaints that they are squeezing independent pharmacies to the breaking point. One...
- 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,...
- Move To Managed Care On Track For Oct. 1, Secretary Says
Despite a recent request to delay by an advisory council, and a low number of signups by hospitals so far, the move to managed care for Kentucky's Medicaid patients should be completed by Oct. 1. "We are prepared to proceed with an Oct. 1 timeframe,"...
- Bidders To Manage Medicaid Unknown; Contracts July 1?
It is not known who bid on taking over the work, but Kentucky is advancing plans to turn Medicaid over to managed-care organizations. The move, which will allow the organizations to take over the day-to-day operations of Medicaid in the state, is meant...
Health News
Independent pharmacists say managed care costs them money
Because two of the three new Medicaid managed-care companies have slashed the dispensing fee they will pay them, independent pharmacists are in danger of going out of business all over the state, pharmacists told the interim joint Health and Welfare Committee yesterday.
But one managed-care firm said that's the cost of saving money for the taxpayers, the reason the state implemented managed care statewide. "We recognize ... there's a big change here for everyone," said Barb Witte, CEO of CoventryCares. "All health care providers are going to have to tighten their belts."
Under the traditional Medicaid system, "pharmacists were paid a 'dispensing fee' per prescription of $4.50 to $5 plus reimbursement for their actual cost of the drug based on an industry formula called the 'maximum allowable cost,'" reports Deborah Yetter of The Courier-Journal.
But the dispensing fee of CoventryCares is only $1 to $1.50. WellCare increased its fee to $3 from $1.50, but cut reimbursement for cost, making the increase only worth about 80 cents. Kentucky Spirit is still paying $4.50 to $5.
Because the maximum allowable cost fluctuates on a monthly basis, pharmacists don't know their return until they file a claim. Often, "pharmacists find they are being paid less than it cost them to buy the drug from a wholesaler," Yetter reports.
"How long will I be able to stay in business losing money?" asked Mayfield pharmacist Sam Willett. "Not very long."
Rep. Tom Burch, D-Louisville, told the MCOs and pharmacists to come to an agreement. "There must be a way to work this out," he said. (Read more)
- Lawmakers Hear More Complaints About Managed Care
Patients with mental illness are being denied medication, forced to try cheaper drugs that have already been proven not to work for the patient, or not getting them in time because of delays in approval. These were some of the complaints of the state's...
- Legislators Hear From New Managed-care Firms; Lawmaker Rates Their Performance With A Show Of Hands From Pharmacists
Kentucky Health News The three companies recently hired to manage Kentucky's Medicaid program outside the Louisville region defended themselves yesterday against complaints that they are squeezing independent pharmacies to the breaking point. One...
- 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,...
- Move To Managed Care On Track For Oct. 1, Secretary Says
Despite a recent request to delay by an advisory council, and a low number of signups by hospitals so far, the move to managed care for Kentucky's Medicaid patients should be completed by Oct. 1. "We are prepared to proceed with an Oct. 1 timeframe,"...
- Bidders To Manage Medicaid Unknown; Contracts July 1?
It is not known who bid on taking over the work, but Kentucky is advancing plans to turn Medicaid over to managed-care organizations. The move, which will allow the organizations to take over the day-to-day operations of Medicaid in the state, is meant...