By Melissa Patrick
Kentucky Health News
FRANKFORT, Ky. -- Only three firms would get multi-million-dollar contracts to manage Medicaid in Kentucky under a bill that passed the state Senate Feb. 12.
Five managed-care organization now oversee care for most Medicaid beneficiaries, and seven have submitted bids for the contracts that will be awarded later this year.
Senate Bill 30, sponsored by Sen. Stephen Meredith, R-Leitchfield, would limit the number of managed care organization contracts to operate the state's Medicaid program to three. The bill passed out of the Senate with a committee substitute on a 29-7 vote Feb. 12.
A bill aimed at decreasing the administrative burden for health-care providers by limiting the number of managed care organizations that administer the states Medicaid program has
"Let's reduce the bureaucracy," Meredith said."We don't need five managed care organizations, they bring no value to the system whatsoever. All they do is deny and delay payment."
The bill would take effect immediately if passed into law since the state is currently working to secure its MCO contracts, and if it passes it would immediately limit the number that could be selected.
Those contracts have already been offered once. Just days before Gov. Andy Beshear took office, former Gov. Matt Bevin's administration awarded the $8 billion Medicaid managed-care contracts to five insurance companies that excluded two companies with current contracts, Passport Health of Louisville and Anthem Inc. Both had said they would appeal the the awards. Beshear has since cancelled the contracts and reopened the bidding process.
Meredith, a former hospitals CEO, has long lamented the administrative burdens that these organizations add to providers, particularly rural hospitals because they have such tight budgets. He noted that the United States spends 30 cents of every health care dollar on administrative fees, five times what other industrialized nations spend.
And to those who would say why not just fix the existing problems, Meredith pointed to HB 69, which became law in 2018 and was supposed to improve the MCO credentialing and enrollment process, along with requiring monthly reports that showed claims, denials, and grievances. The problem is, he said, all of those issues still exist.
Senate Minority Leader Morgan McGarvey, D-Louisville, voted no on the measure and said that while he understands the provider's ongoing frustrations with the current system, "My fear is that this bill wont' fix those problems." He also did not like that this bill ties the executive branch's hands.
Sen. Danny Carroll, R-Paducah, speaking in favor of the bill, said that as someone who runs a small organization for children with disabilities, he battles with the MCOs "every day" over wrongly denied claims and delays in payments. He added that it would be helpful to his organization to only have to deal with three sets of rules, instead of five.
"It will make it less complicated. It will save money," he said. "And at a time when Medicaid reimbursements are so low, I think we owe it to providers at every level to allow them to save money wherever they can and reducing administrative cost by limiting these numbers, that will allow money to be saved."
Kentucky Health News
FRANKFORT, Ky. -- Only three firms would get multi-million-dollar contracts to manage Medicaid in Kentucky under a bill that passed the state Senate Feb. 12.
Five managed-care organization now oversee care for most Medicaid beneficiaries, and seven have submitted bids for the contracts that will be awarded later this year.
 |
| Sen. Stephen Meredith presents SB 30 to limit Medicaid managed-care contracts to three. Photo: LRC Public Information |
A bill aimed at decreasing the administrative burden for health-care providers by limiting the number of managed care organizations that administer the states Medicaid program has
"Let's reduce the bureaucracy," Meredith said."We don't need five managed care organizations, they bring no value to the system whatsoever. All they do is deny and delay payment."
The bill would take effect immediately if passed into law since the state is currently working to secure its MCO contracts, and if it passes it would immediately limit the number that could be selected.
Those contracts have already been offered once. Just days before Gov. Andy Beshear took office, former Gov. Matt Bevin's administration awarded the $8 billion Medicaid managed-care contracts to five insurance companies that excluded two companies with current contracts, Passport Health of Louisville and Anthem Inc. Both had said they would appeal the the awards. Beshear has since cancelled the contracts and reopened the bidding process.
Meredith, a former hospitals CEO, has long lamented the administrative burdens that these organizations add to providers, particularly rural hospitals because they have such tight budgets. He noted that the United States spends 30 cents of every health care dollar on administrative fees, five times what other industrialized nations spend.
And to those who would say why not just fix the existing problems, Meredith pointed to HB 69, which became law in 2018 and was supposed to improve the MCO credentialing and enrollment process, along with requiring monthly reports that showed claims, denials, and grievances. The problem is, he said, all of those issues still exist.
Senate Minority Leader Morgan McGarvey, D-Louisville, voted no on the measure and said that while he understands the provider's ongoing frustrations with the current system, "My fear is that this bill wont' fix those problems." He also did not like that this bill ties the executive branch's hands.
Sen. Danny Carroll, R-Paducah, speaking in favor of the bill, said that as someone who runs a small organization for children with disabilities, he battles with the MCOs "every day" over wrongly denied claims and delays in payments. He added that it would be helpful to his organization to only have to deal with three sets of rules, instead of five.
"It will make it less complicated. It will save money," he said. "And at a time when Medicaid reimbursements are so low, I think we owe it to providers at every level to allow them to save money wherever they can and reducing administrative cost by limiting these numbers, that will allow money to be saved."
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