Medicaid

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.

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.

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.

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.

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.

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.

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.

Members of a Christians-only health insurance plan that has been ordered to cease operations in Kentucky should get different policies immediately, the state Department of Insurance advised. The move follows Franklin County Circuit Judge Thomas Wingate's ruling earlier this month that Medi-Share, a Florida-based cost-sharing ministry, can't operate in Kentucky because it doesn't meet the state's insurance code.

The CEO of a major Medicaid managed care company (MCO) is criticizing Kentucky for the way the state deals with businesses like his. Michael Neidorff is the CEO of Centene, which operates Kentucky Spirit, one of three statewide MCOs that has managed Medicaid patients for the state since last year.

A progressive economic group says Kentucky should expand Medicaid under the Affordable Care Act based on recently release Census data. The Kentucky Center for Economic Policy points to data that shows the percentage of Kentuckians without insurance dropped last year based on early elements of the health care law.

Kentuckians on Medicaid now have the opportunity to change healthcare providers for the first time in months. Open enrollment for all of the state except Louisville started Monday. It's the first time since Medicaid was privatized that residents can choose a new private operator to handle their care.

The Kentucky Cabinet for Health and Family Services has apologized to a federal judge and is asking him to drop a contempt order against the agency. U.S. Senior Judge Karl Forester held the agency in contempt last month after ruling that the cabinet did not comply with his order to process thousands of requests from Appalachian Regional Healthcare patients who wanted to switch Medicaid managed-care companies.

Much of the media attention regarding Thursday's Supreme Court ruling understandably focused on the upholding of the individual mandate. Less publicized was another part of the ruling--the part that said the health care law's expansion of Medicaid placed an unfair burden on states.

The process of opening the Louisville area to Medicaid competition is underway. Passport Health Plan has run Medicaid in the area for 15 years, but the state has been ordered by the federal government to allow at least one more private operator to do business in the region.

A Kentucky lawmaker says implementation of a federal mandate to allow private companies to compete for Medicaid contracts in Louisville could be delayed. Currently, Medicaid in Louisville and the surrounding area is managed by the private company Passport Health Plan. But the federal government has ordered Kentucky to open the area to competition. And the company United Healthcare is already attempting to gain a foothold in the region.

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