Government
4:00 pm
Wed February 15, 2012

MCO's Address Billing Issues

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, hospitals and other health care providers spent previous weeks telling lawmakers horror stories about working with the MCOs. One such story included a pre-authorization to deliver a baby that didn't come through until weeks after the child was born.

CoventryCares Vice President Kevin Conlin told the committee his company's payment backlog will be cleared by Friday, and the other issues are nearly resolved.

“We accept accountability for the fact that we contributed to some of the issues that providers are facing," he said. "I trust you can see we’ve taken this seriously, we’re bringing significant resources to improve this and I’m encouraged we’re seeing some early success.”

The other two MCOs both say they are quickly reducing their backlogs. But they blamed late repayment and pre-authorizations on third party administrators used by doctors.

One lawmaker, Republican Senator Joe Bowen, wondered aloud if these problems would have occurred if the MCO's had more time to put their system in place.

“You all didn’t have the opportunity for a soft opening, you had a grand opening and more people showed up than you anticipated. I mean is that fair to say?" Bowen asked.

"I would say there was an extreme urgency between October 15 and November 1stto get contracts done and it was terrific to see the provider community had the urgency to get that done,” said WellCare President Mike Minor.

By the end of the committee, the MCOs had assured lawmakers that one way or the other, problems will be resolved immediately.

There is one other MCO in Kentucky—Passport has operated in the Louisville area for years.