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.
The departure of one of three statewide Medicaid operators next year is once again raising concerns about adequate medical coverage in parts of the state. Earlier this year, coverage was one of the issues brought up between Coventry Cares, another operator, and hospital chain Appalachian Regional Healthcare in a lawsuit over contract issues. At the time, state officials pointed to the other two operators as proof of coverage. But now one of those operators, Kentucky Spirit, is leaving next July.
Kentucky lawmakers continue to chastise three of the state's Medicaid Managed Care organizations for mismanagement.
Representatives of Kentucky Spirit, Wellcare of Kentucky and Coventry Cares appeared before the program review committee today. Legislators wanted to know whether they had solved problems brought up by health care providers in a January committee meeting.
The MCOs all said the problems were mostly solved and that operations were improving every day. But independent pharmacists and mental health care providers disagreed.
Kentucky's Medicaid Managed Care Organizations say they have fixed a number of issues with reimbursements to pharmacists.
CoventryCares, WellCare and Kentucky Spirit took over management of the state's Medicaid system last year. Since then, doctors and pharmacists have come forward to say the organizations are poorly managed and the reimbursements for care are too low.
Executives from the organizations told a legislative committee today that the early kinks have been worked out of the system. But there were pharmacists in attendance who disagreed.