House Notes: Measures aimed at fix managed care frustration and pill mill bill pass

The House unanimously approved a pair of bills aimed at cleaning up “unintended consequences.”

One deals with the Medicaid managed care system that has left many hospitals, doctors, dentists and other providers complaining about getting paid on time by the managed care firms when they provide health care to Medicaid enrollees.

House Bill 5, sponsored by House Speaker Greg Stumbo, sets up an administrative review panel in the Department of Insurance to arbitrate billing disputes between managed care companies and providers.

Legislators have been bombarded by conflicting messages from providers and the managed care companies that claim they are paying the bills swiftly and any remaining problems lie with the third-party billing firms providers use. Stumbo said the truth “probably lies somewhere in the middle.”

It passed 99-0. One change Stumbo made was to drop the emergency clause to give the Insurance Department more time to put in place the framework for handling disputes. That was requested by Gov. Steve Beshear’s administration, Stumbo said.

Two of Stumbo’s fellow Democrats from rural areas said unless something is done, hospitals, pharmacies and other providers will close down because the backlog of delayed payments for services will break them.

“It’s getting worse for every provider in the state,” said Rep. John Will Stacy, who is a pharmacy owner from Morgan County. “This is the only way this will get resolved.”

Pill mill bill fix approved

The “clean-up bill” is aimed at solving confusion with HB1 from 2012 that tightens restrictions on prescription pills.

For instance, it would clarify that hospitals wouldn’t have to submit a report to the prescription monitoring system, KASPER, every time a patient needs additional pain medicine like morphine.

The measure, HB 217, also was sponsored by Stumbo. And it, too, passed 99-0 on Wednesday.