Tagged: MCO's

Kentucky State Auditor Adam Edelen says there's a lack of oversight by the Cabinet for Health and Family Services over Medicaid Managed Care Organizations.

In the second part of the statewide audit released today, Edelen says the MCOs didn't provide enough information to ensure grievances from members and providers were handled timely or that federal compliance requirements were met.

A bill  moving Medicaid late payment claims to the Department of Insurance appears to have some support in the state Senate.

House Bill 5 would take prompt pay issues with the Medicaid managed care system and put it through the Insurance Department's current claims process. Currently, the Cabinet for Health and Family Services deal with late claims.

Representatives of the state's health department and various hospital executives say almost two years later they are still having payment issues with Medicaid managed care organizations.

Kentucky officials are once again facing the prospect of lawsuits over efforts to expand managed health care within  Medicaid.
 

This time, it's Passport Health Plan that is threatening to sue, based on what they call broken rules and promises made to them.