Medicaid Managed Care Organizations

Medicaid managed care organization Kentucky Spirit has officially exited the commonwealth, leaving health officials with approximately 125,000 members to transfer to other MCOs.

The move occurred in the early morning hours Saturday after the Kentucky Court of Appeals had previously denied the state’s emergency motion for a mandatory injunction to keep Kentucky Spirit from leaving.

governor.ky.gov

Gov. Steve Beshear has vetoed a bill sponsored by House Speaker Greg Stumbo that would require prompt payment in the Medicaid managed care system. 

The governor was expected to veto the bill, claiming it would cost the state too much money.

But in turn, Beshear says he will implement the spirit of the bill, including allowing the Department of Insurance to investigate late payment claims. Beshear also promised the administrative side of the managed care system would work better.

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.