Tagged: Medicaid

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.

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.

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.