Medicaid

Health
6:39 am
Wed March 6, 2013

Haslam: Decision on Medicaid Expansion to Come by End of the Month

Tennessee Gov. Bill Haslam (right)

Tennessee Gov. Bill Haslam says he will make up his mind on whether to expand the state’s Medicaid program by the end of the month. He says he’ll leave time for the state legislature to consider his decision.

There’s no pressing deadline except that the state legislature intends to wrap up work in April and Haslam needs lawmakers to sign off either way. If he does go along with the Affordable Care Act and expand the state’s Medicaid program, it could take a lot of convincing.  

“If the decision is no, then their discussion is short I think. If the decision is yes, then I think they’ll need a decent amount of time to discuss that,” said the Republican Governor.

Two Republican lawmakers are still trying to advance bills that would bar the state from expanding Medicaid. They argue the state still can’t afford it even though the federal government pays the bill for the first three years.

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Health
2:51 pm
Wed February 20, 2013

Kentucky Hospitals, Health Department Voice Concerns, but MCOs Say Groups Aren't Engaging With Them

Representatives of the state's health department and various hospital executives say almost two years later they are still having payment issues with Medicaid managed care organizations.

Speaking before a House budget subcommittee on health issues, the two groups described situations in which payment for care they administrated months ago were still outstanding claims.

Scott Lockard works in the Clark County Health Department and told lawmakers the state public health department was still owed more than $18 million in late payments. More than $14 million of that is with Kentucky Spirit, which is trying to break its contract and leave the system.

But he added that conversations about those payments are ongoing.

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Health
12:46 pm
Wed February 13, 2013

Senate Committee Backs Bill Requiring Kentucky Medicaid Providers to Publish Prescription Prices

A bill requiring Kentucky Medicaid managed care operators publish a list of prescriptions and reimbursement prices on Wednesday passed a state Senate committee, following prodding from  independent pharmacists asking for access to pricing standards before they fill prescriptions.

The group of independent pharmacists told lawmakers that they are still having trouble with reimbursements from the state's Medicaid managed care operators. And they said they were also still being dramatically undercut on prescription reimbursements when they did receive them.

Pharmacist Jonathan Van Lahr  said his goal was  to see transparency in the process.

"We are not asking to be paid exorbitant prices for these medications we dispense, just not to lose money. Or at least, let me know I'm going to lose money before I fill it," he says.

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Health
3:21 pm
Wed January 9, 2013

Kentucky Senate Chair Wants Legislative Approval for Health Exchange, Medicaid Expansion

The chairman of a Kentucky Senate committee is promising to file legislation aimed at preventing Gov. Beshear from setting up two major pieces of the federal health care law without legislative approval.

The Courier-Journal reports Senate Health and Welfare Committee Chair and Louisville Republican Julie Denton says she doesn’t want the Governor to be able to unilaterally establish a new statewide health care exchange or expand Medicaid services to more Kentuckians. Denton and other Obamacare opponents say the state can’t afford the exchange or expanded Medicaid offerings.

Denton’s bill would make such moves contingent on General Assembly approval. Gov. Beshear has already taken steps to create a statewide health care exchange by 2014, which would allow those who don’t get insurance at work to buy a plan from a private company and receive government subsidies in the process.

The Medicaid expansion would allow those earning less than 133 percent of the poverty rate to qualify for the program. Beshear says he is still considering the Medicaid expansion, while House Speaker Greg Stumbo says he fully supports the move.

Health
10:37 am
Thu January 3, 2013

Speaker Stumbo Favors Medicaid Expansion in Kentucky

The Speaker of the Kentucky House says it’s a no-brainer for Kentucky to expand its Medicaid program under the Affordable Care Act.

Under the health care law, states can expanded their Medicaid rolls to 138 percent of the poverty line, with the federal government picking up the tab for three years. 

Kentucky Governor Steve Beshear has yet to decide whether Kentucky will expand, saying he will calculate costs after 2017, when the feds pay only 90 percent of the expansion.

But Democratic House Speaker Greg Stumbo says he's encouraging Beshear to commit to Medicaid expansion now.

“I think it would be a penny wise and a pound foolish not to find the money,” Stumbo says.

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Health
1:12 pm
Tue December 11, 2012

Legal Issues with Kentucky Spirit Remain; Passport Withdraws Medicaid Complaint

Weeks after their announced departure from Kentucky’s Medicaid managed care system, operator Kentucky Spirit and the state are still locked in a legal battle.

Both sides have sued each other, blaming the other for the situation. Kentucky Spirit announced their departure, scheduled for the middle of 2013, due to massive losses in the system.

In an interim committee meeting Tuesday, Kentucky lawmakers asked for an update on what the state hoped to recoup financially because of Kentucky Spirit’s decision.

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Health
6:00 am
Sat November 3, 2012

New Rule Continues Medicaid Burden on Kentucky's Independent Pharmacists

A new policy by a statewide Medicaid operator has independent pharmacists up in arms again. Earlier this year, pharmacists were the first group to alert lawmakers to problems with the managed care system. But they failed to get a bill protecting their co-pays signed into law.

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Health
12:16 pm
Tue October 23, 2012

Kentucky Spirit Sues to Officially Break Its Medicaid Contract

Struggling Medicaid operator Kentucky Spirit has followed through and is suing to end its contract with the state. Kentucky Spirit announced last week it was leaving the commonwealth, because it could not operate without massive losses.  Now, it is suing in Frankfort courts to make it official.

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Health
3:45 pm
Mon October 22, 2012

Medicaid Insurance Leaves Heavy Burden on WellCare

The departure of one of three statewide Medicaid operators next year is once again raising concerns about adequate medical coverage in parts of the state. Earlier this year, coverage was one of the issues brought up between Coventry Cares, another operator, and hospital chain Appalachian Regional Healthcare in a lawsuit over contract issues.

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Health
1:00 am
Mon October 22, 2012

Life After Kentucky Spirit: Passport, Humana Ready to Expand?

As the fallout continues from the announced departure of statewide Medicaid operator Kentucky Spirit, many other Medicaid operators are already looking to take their place. Kentucky Spirit announced last week they would break their contract with the state early. State officials say they won’t re-open those statewide contracts to replace Kentucky Spirit until the current contracts expire.

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