More complaints lodged about Medicaid managed care; lawmakers demand answers

Complaints continue to pile up about the state’s new Medicaid managed care plans, which cover about 560,000 Kentuckians. Lawmakers are hearing gripes from providers who say they are not getting paid, and from patients and clinics who say the three managed-care companies take too long to give permission for certain care.

“It’s a drastic change to the system,” Neville Wise, the state’s acting Medicaid commissioner, told the Senate Health and Welfare Committee yesterday. “We didn’t expect the level of issues that we had.”
Sen. Julie Denton, a Louisville Republican who chairs the committee, “expressed outrage about a case in which she recently called the president of one company trying to get care authorized for a battered domestic violence victim who sought treatment at a Lexington clinic on a Friday afternoon,” reports Deborah Yetter of The Courier-Journal.
Despite Denton’s call to Coventry Health Care, the woman was not able to get a scan for a shoulder injury until the following Monday. “This woman had to go in pain all weekend because she couldn’t get the services she needed,” Denton said. “This is not acceptable, and this is only one instance that I know of.”
Denton also asked about late payments to providers. “The payment issues have gone on way too long, and it should have been better,” Wise responded.
Kentucky moved to three managed care companies Nov. 1, in an effort to save the state money and balance the Medicaid budget. (Read more)
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