Tuesday, February 26, 2013

Bill to make Medicaid managed-care firms pay up, and more promptly, nears final form in House and will get attention in Senate

By Molly Burchett and Al Cross
Kentucky Health News

The complaints by many health-care providers about Medicare managed-care firms' delay or denial of payment claims appears to be generating a bipartisan solution in the General Assembly. A bill on the House floor that would transfer late-payment complaints to the state Department of Insurance, which enforces Kentucky's prompt-payment laws, appears to have support in the Senate.

House Bill 5 would apply the prompt-payment laws to managed-care organizations and would move Medicaid late-payment complaints to the insurance department; those are now handled by the Cabinet for Health and Family Services, which administers Medicaid.

Hospitals, doctors and other health care providers have complained that the cabinet is not resolving their payment disputes with managed-care firms. The bill cleared the House Health and Welfare Committee Feb. 21 and is awaiting a vote on the House floor. The bill is sponsored by House Speaker Greg Stumbo.

Sen. Julie Denton, chair of the Senate Health and Welfare Committee, told Kenny Colston of Kentucky Public Radio that she plans to give the bill a hearing and supports its intent to make managed care organizations pay providers. "I think anything we can do to have more oversight and more assistance in keeping them in compliance with their contracts is a welcome breath of fresh air," she said.

Senate President Robert Stivers said he has concerns about the bill affecting the MCOs contracts with the state. But he said his chamber will take a look at the bill, Colston reports. The cabinet has had the same concerns, and some other objections that are to be addressed by House floor amendments.

Kentucky providers report being burdened by a lack of or delayed payments from the new managed-care system. Kentuckians have called for immediate action by state government to help fix these issues on behalf of providers and patients, which has prompted this bipartisan legislative response.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

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