Doctor and former Lt. Gov. Mongiardo blasts managed care as a 'scam,' calls for reforms

05/21/2013 11:49 AM

Former Lt. Gov. Daniel Mongiardo, a physician, said the governor was wrong to veto a bill aimed at better regulating Medicaid managed care, which Mongiardo said is a “an absolute financial scam.”

Mongiardo told Pure Politics that the Health and Family Services Cabinet shouldn’t be the arbitrator of billing disputes between managed care companies the state hired to hold down Medicaid costs and the doctors, hospitals and other providers who treat the poor and disabled who rely on Medicaid.

Mongiardo said the veto by his former running mate, Gov. Steve Beshear, was an admission that Kentucky can’t save money in Medicaid unless the managed care companies hold back payments.

“He’s not going to come on your show and tell you this, but what the state is saying is that: ‘If we can’t take money away from the provider, we can’t save money.’ So that’s not saving money … that’s stealing from those who are providing health care and not paying them,” Mongiardo said (starting at 4:30 of the interview).

“It’s an absolute financial scam,” he added (5:15). “Don’t get me wrong, there is abuse in the system. But you cannot just shotgun the system and say, ‘We’re going to cut everyone across the board’ and solve the problem. We absolutely do need an innovation in health care to solve the problem, but we’re not doing it with managed care.”

State Medicaid officials have said in response to criticism that the managed care system will save money by focusing treatment on wellness and preventative health to stave off more serious health problems and better manage chronic diseases.

But Mongiardo said that’s not happening with managed care yet. (6:00)

He said the state needs to step in and better regulate the manged care systems. But he also said Beshear was right to expand Medicaid as part of the Affordable Care Act, which would cover 308,000 low income Kentuckians (that part of the interview is forthcoming).

Since leaving office, Mongiardo has returned to his medical practice as an ear, nose and throat doctor. He sees patients in his home town of Hazard, as well as in Central Kentucky — both in Lexington and Cynthiana.

The interview began with Mongiardo answering a question about how many of his patients are on Medicaid:

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