Judge Rules Against Medicaid Provider

May 29, 2013

A judge has ordered Kentucky Spirit to pay for preventative care that local health departments across the state provide to school children.

The Courier-Journal reports Franklin Circuit Judge Phillip Shepherd issued the ruling Tuesday.

The Medicaid-managed care provider stopped paying for such services last summer, saying it wasn't obligated to cover the care under its contract with the state.

Director of Hopkins County Board of Health Jack Morris said if the ruling holds up on appeal, his county will be in line for $160,000 from these types of services Kentucky Spirit declined to pay.

“Well-child developmental exams, immunizations, school exams -  basically any service that we provided at the health department is provided within a school setting,” Morris said. “And they refused to pay for any service provided outside the main health department.”

Kentucky Spirit claims it didn’t understand the obligations despite signing a binding three-year contract with the state.

The estimated $8 million order affects 59 public health departments like Hopkins and the schools they serve.