With Tensions High, Kentucky Organizes Medicaid Insurance Meetings

Jun 12, 2013

The organizations the Commonwealth contracts to provide Medicaid insurance benefits are under fire from regional hospitals and doctors for late or missing payments.

In western Kentucky, that fire has focused on managed care organization Kentucky Spirit.  The state is responding with a series of public meetings to relieve tensions. 

Governor Steve Beshear initiated a transfer of Kentuckians from the pay-per-patient system to managed care organizations, or MCOs, almost three years ago. Since then, the switch has generated controversy over payment deadlines and appeals processes.

The Department of Insurance has conducted eleven investigations of failed or disputed payments in the region, most with MCO Kentucky Spirit, while almost 600 statewide investigations are still underway.

Murray-Calloway County Hospital alone has billed Kentucky Spirit for $3.8 million, and received no payments.  MCCH officials say they’ve met with officials from the Missouri-based company, but no progress has been made.

The Cabinet for Health and Family Services hopes to ease tensions between Kentucky insurance and health providers with a series of public meetings in the region.

The first is June 20 at Pennyrile Forest State Park. The second and final face-to-face session will be at Murray State University’s Curris Center July 15.