Move to managed care on track for Oct. 1, secretary says

Despite a recent request to delay by an advisory council, and a low number of signups by hospitals so far, the move to managed care for Kentucky's Medicaid patients should be completed by Oct. 1.

"We are prepared to proceed with an Oct. 1 timeframe," said Janie Miller, secretary of the Cabinet for Health and Family Services, right, as she updated the Medicaid Oversight and Advisory Committee Monday. "I know it is quick and it is coming."

The advisory council had asked the cabinet to delay, saying the Oct. 1 deadline did not give providers enough time to review contracts. Several legislators also feel the move is happening too quickly. "Oct. 1 just seems a little scary for some of us," said Sen. Julie Denton, R-Louisville. She said "doctors, pharmacists and other providers have contacted her to voice concerns that they don't have enough information about which managed care company to sign on with," Deborah Yetter of The Courier-Journal reports.

As of last Wednesday, "Only 15 or so of the state’s [109] hospitals had signed on with one of the three managed care providers," according to Miller, Ronnie Ellis reports for CNHI News Service. "She said she wants to see about 89 hospitals join one or more of the three networks but the contracts provide for “out of network” services if enough hospitals don’t join in rural or isolated areas." (Read more)

The move to managed care organizations is the state's answer to plug a $139 million hole in the Medicaid budget. Privatizing the program by using managed care will mean providers will be paid on a per-patient, per-month basis, which Gov. Beshear said will save $1.3 billion over three years. Right now, providers are paid on a fee-for-service basis, meaning they bill for each service that is provided. The move will affect more than 730,000 Kentuckians and will be run by four MCOs statewide, including Passport. As it has for several years, Passport will continue to provide managed care for 170,000 Kentuckians in Jefferson County and the surrounding area.

Within two weeks, 560,000 Kentuckians outside of the Passport jurisdiction will receive information packets about which of the other three companies will handle their care. Membership cards will be mailed in September, Yetter reports. Before the new program can be launched, the state must showed the federal Centers for Medicare and Medicaid Services it is ready. Miller said that if the program is not deemed to be ready, there would be a delay, Yetter reports. (Read more)