MCO's

Government
5:16 pm
Wed July 31, 2013

State Auditor: Kentucky Isn't Ready for Expanded Medicaid Coverage

Credit 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.

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Government
3:15 pm
Fri March 22, 2013

Edelen Finds Lack of Oversight in Statewide Audit

Credit kentucky.com

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.

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2013 KY General Assembly
10:09 am
Mon February 25, 2013

Bill Dealing With Medicaid Late Payments Has Support in Senate

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.

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Government
2:48 pm
Wed February 20, 2013

Hospitals, Health Department Voice Concerns, but MCOs Say Groups Aren't Engaging With Them

Credit Wikimedia Commons

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.

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Health
11:41 am
Fri November 2, 2012

Passport Files Formal Complaint over Louisville Medicaid Contracts

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.

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Health
11:32 am
Tue October 23, 2012

Kentucky Spirit Sues to Officially Break Its Medicaid Contract

centene.com

Struggling Medicaid operator Kentucky Spirit has followed through and is suing to end its contract with the state.

Kentucky Spirit announced last week it was leaving the commonwealth, because it could not operate without massive losses.  Now, it is suing in Frankfort courts to make it official.

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Health
2:54 pm
Fri October 19, 2012

Life After Kentucky Spirit: Passport, Humana Ready to Expand?

centene.com

As the fallout continues from the announced departure of statewide Medicaid operator Kentucky Spirit, many other Medicaid operators are already looking to take their place.

Kentucky Spirit announced last week they would break their contract with the state early. State officials say they won’t re-open those statewide contracts to replace Kentucky Spirit until the current contracts expire.

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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.

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