Gov. Beshear vetoes Medicaid managed care bill and proposes his own plan to handle billing disputes

04/05/2013 02:42 PM

Gov. Steve Beshear vetoed a measure Friday designed to address the continuing frustrations between doctors and Medicaid managed care companies but announced an approach to fix billing disputes.

House Bill 5, sponsored by House Speaker Greg Stumbo, would have set up an administrative review process to sort out disputes between Kentucky’s Medicaid managed care companies and doctors and hospitals who say they’re not getting paid like they should be for helping Medicaid patients.

Stumbo previously said that he expected the governor to veto the bill but that Beshear had personally vowed to “crack the whip” to make sure the billing problems stop.

Beshear said language in HB5 could have interfered with contractual relations between providers and managed care organizations and could possibly expand cost significantly.

“Look, I understand and appreciate the intent behind the bill and the commitment of its sponsors and supporters to maintaining reliable and accessible health care in their communities,” Beshear said (at :20). “They were presented with complaints from providers about not being reimbursed in a timely manner for service and they tried to respond to those complaints.”

Beshear said he agreed the issues with payment needed to be addressed, but that they must also address resistance from some providers and patients to the changes being made to the health care system in the state.

As a solution, the governor announced that his plan would solve what he called, “prolonged implementation problems.”

The governor’s five-step plan includes moving responsibility of reviewing payment disputes to the Kentucky Department of Insurance, which was the intent of HB5.

Other points in the plan include having the MCOs reconcile all outstanding accounts, an audit of each of the companies conducted by the Department of Insurance, educational forums for companies and providers and emergency room improvements.


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