Managed Care Organizations

wikipedia.org

Kentucky’s State Auditor Adam Edelen is concerned about the Commonwealth’s ability support an added 300,000 resident’s to its Medicaid program. Expanded Medicaid coverage next year comes as part of the rollout of the Affordable Care Act.

The Hopkins County Health Department is continuing to wait for over $300,000 of reimbursement from one of the Commonwealth’s three managed-care organizations. 

kentucky.com

State Auditor Adam Edelen has released ten recommendations for a more efficient Medicaid Managed Care system in Kentucky.

For weeks, the MCOs, lawmakers, health care providers and patients have tussled over the new system, which was implemented quickly to plug a budget gap.

MCOs have promised lawmakers that the majority of problems are fixed, but some areas like pharmacy and mental health, are still having issues.

Rather than directly auditing the managed care organizations, Edelen instead looked into how the system was using taxpayer’s funds.