Bidders to manage Medicaid unknown; contracts July 1?

It is not known who bid on taking over the work, but Kentucky is advancing plans to turn Medicaid over to managed-care organizations. The move, which will allow the organizations to take over the day-to-day operations of Medicaid in the state, is meant to improve efficiency and save money, The Courier-Journal's Deborah Yetter reports.

"The proposed changes will dramatically reshape the program for more than 500,000 of the roughly 800,000 Kentuckians who depend on Medicaid for health care," Yetter writes. "It will not affect those in nursing homes or in certain programs that serve individuals with mental disabilities."

Gov. Steve Beshear promised the move earlier this year in his proposal to fill a $166 million gap in Medicaid funding, which comes mainly from the federal government. His administration believes moving to managed can save about $139 million in Medicaid costs next year. There are concerns about the plan, not the least of which how to make a smooth transition for patients. "We want to make sure people are able to access their doctors and access to care is not threatened," said Jodi Mitchell, executive director of Kentucky Voices for Health.

Rural pharmacists are also worried about the impact, since legislators "have not ruled out allowing mail-order prescriptions for maintenance drugs, such as blood pressure pills," Yetter reports. If mail-order is allowed, pharmacists are concerned there would be less contact with patients and that rural, independently-owned pharmacies would be threatened. "With mail order you are taking revenue out of the state," said Clay Rhodes, president of the Kentucky Pharmacists' Association. "Mail order can survive on the thinnest of margins and your rural pharmacy more than likely can't."

The bidding process is a complicated one, Yetter reports, and it is unclear how Passport Health Plan, a managed-care organization that already takes care of 30 percent of the state's Medicaid recipients in the 16-county Louisville region, fits in. Bidders are asked to submit bids "for the Passport region alone, another for the whole state and the other for the entire state except for Passport," Yetter reports.

Contracts will be awarded July 1. Yetter confirmed Humana Inc. has chosen not to bid. (Read more)