Edelen Says He’ll Audit Private Medicaid Operators This Year

After months of mounting problems, State Auditor Adam Edelen says he will launch a full investigation intoKentucky’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 […]

Denton Says Lawmakers Will Remove CoventryCares From Medicaid System if Tough Bargaining Continues

Kentucky Senator Julie Denton says the state’s largest private Medicaid company is underpaying and threatening healthcare providers, and she says lawmakers may kick the company out of the state Medicaid system if the behavior persists. CoventryCares is one of three new private Medicaid Managed Care Organizations (MCOs) that began business in the commonwealth last year. […]

Healthcare Provider Sues Medicaid Care Operators

The main healthcare provider for eastern Kentucky, Appalachian Regional Healthcare, has filed suit against two of the state’s four Medicaid managed care operators. In complaints filed this week, Appalachian Regional Healthcare alleges Coventry Health and Kentucky Spirit Health Plan owe the provider over $17 million in back payments. Kentucky privatized Medicaid statewide last November to […]

Lawmakers Take Medicaid MCOs to Task for Not Solving Pharmacy, Mental Health Care Issues

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. The MCOs all […]

Managed Care Executives Say They’ve Fixed Problems With Payments

Officials with Kentucky’s Medicaid managed care organizations say they’re on track to resolve any problems with reimbursements to doctors and pharmacists. CoventryCares, WellCare and Kentucky Spirit began administering Medicaid statewide last fall, and they’re off to a rocky start. Executives with the three organizations are in Frankfort this week for a series of committee hearings. Doctors, […]

Managed Care Operators Struggle Early, Kentucky Spirit Loses Members

With reporting from Kentucky Public Radio’s Capitol Reporter Kenny Colston. Since taking over a portion of Kentucky’s Medicaid system, Managed Care Organization (MCO) Kentucky Spirit Health Plan has lost nearly 70,000 members while some healthcare professionals are questioning whether the three new private operators can handle the state’s Medicaid program. Kentucky Spirit, CoventryCares and WellCare […]

Beshear Confident Medicaid Managed Care Problems Will Be Resolved

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 […]

Medicaid Providers Complain of Managed Care Mismanagement

Kentucky’s private Medicaid providers say they need immediate changes in the state Medicaid system. Kentucky turned the system over to managed care providers four months ago. And today doctors, pharmacists and hospital executives told a Senate committee how disastrous the change has been. Kentucky currently contracts with four Managed Care Organizations, known as MCOs. Passport […]