Medicaid

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.

After months of mounting problems, State Auditor Adam Edelen says he will launch a full investigation into Kentucky’s statewide Medicaid Managed Care system. Edelen created a Medicaid task force in February after taking a first look at the managed care system. He also gave recommendations to managed care companies, health care providers and the state on how to make the system run better in the future.

Kentucky lawmakers continue to chastise three of the state’s Medicaid Managed Care organizations for mismanagement. Representatives of Kentucky Spirit, Wellcare of Kentucky and Coventry Cares appeared before the program review committee today. Legislators wanted to know whether they had solved problems brought up by health care providers in a January committee meeting.

Governor Steve Beshear says the problems with Kentucky’s new Medicaid Managed Care system will be resolved.
 Beshear pushed for the managed care system last year to take some of the administrative burden of Medicaid off of the state. But earlier this week, doctors, pharmacists and hospital officials told lawmakers there were significant problems with the system.

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