Medicaid Providers Complain of Managed Care Mismanagement

by Kenny Colston on February 8, 2012

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 is based in Louisville, while Kentucky Spirit, WellCare and Coventry Cares operate statewide.

The providers say the three statewide MCOs are mismanaged and ineffective. They say their claims aren’t reimbursed on time, and the MCOs aren’t consistent about pre-authorizing treatments and medication.

Shawn Jones is a doctor in Paducah and the president of the Kentucky Medical Association. He says the pre-authorization system needs to be overhauled.

“This bureaucratic nightmare needs to change,” Jones said. “First the MCOs need to pare down the number of procedures and treatments that require pre-authorization. Second, they need more uniform and timely processes to review the pre-authorization requests, and thirdly some sort of appeals process should be established.” [click to continue…]

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Kentucky To Expand Medicaid Managed Care But Will Increase Oversight

by Tony McVeigh February 9, 2011

The state saved millions of dollars in Louisville through a managed care program called Passport, even though questionable spending ultimately led to a management shakeup. Health and Family Services Secretary Janie Miller says any new programs will face strong oversight.

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Cook Says Changes Are Coming To Passport

by Gabe Bullard November 18, 2010

The board of directors of Medicaid manager Passport Health Plan met Thursday for the first time since an auditor’s report revealed inappropriate spending and conflicts of interest within the agency. Passport CEO and board chair Dr. Larry Cook says an interim-CEO will be hired to relieve him of his duties in that position.

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Passport Rules to Change June 1

by scrosby March 14, 2009

U.S. rules regarding the need for passports in certain situations will change in less than three months.   The new rule requires people coming into the U.S. from Canada, Mexico, Bermuda and the Caribbean to present a passport book or card.  The previous rule required only a driver’s license or birth certificate. The Kentucky Department […]

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