Glasgow Daily Times, Glasgow, KY

December 11, 2012

Lawmakers grill Medicaid commissioner over late payments

By RONNIE ELLIS
CNHI

FRANKFORT — It was almost a tale with two versions.

Lawrence Kissner, Kentucky’s Commissioner of Medicaid Services, seemed pleased to tell the Interim Joint Committee on Health and Welfare how well the state’s move to managed care for most Medicaid patients is progressing.

But Committee Chair Sen. Julie Denton, R-Louisville, and some other lawmakers, wanted Kissner to explain why the managed care organizations are so slow in paying providers, especially hospitals who the lawmakers say suffer from long overdue bills to the MCOs.

“The reality is the providers aren’t getting paid,” Sen. Joe Bowen, R-Owensboro, told Kissner. “Their accounts payable are mounting and it’s creating a hardship for all of them, large and small.”

Hospitals and other providers have complained for months that Kentucky Spirit, Coventry Cares and Wellcare, the three companies serving Medicaid patients outside the Louisville area, are slow to reimburse for services or frequently disallow services.

(Kentucky Spirit has said it will leave Kentucky because it has found serving its members is more expensive than data provided by the state indicated at the time they signed their contract. Kissner said Tuesday the MCO has not yet left and he anticipates litigation involving the company.)

Kissner told the committee the state Department of Insurance has found two of the three — Kentucky Spirit and Wellcare — slow to make payments and ordered them to adopt corrective action plans.

For the full story, see the print or e-edition of Wednesday's Glasgow Daily Times.