Medicaid Commissioner under budget and under fire when it comes to managed care

12/11/2012 05:11 PM

The shift to managed care has helped Kentucky on the financial side, but state Medicaid officials remain on the hot-seat as Kentucky hospital administrators and doctors continue complaining of slow payments and cumbersome procedures.

First the good news. State Medicaid Commissioner Lawrence Kissner told lawmakers on the Interim Health and Welfare Committee the department is $40 million under budget through October.

But overall, it was an uncomfortable meeting for Kissner, who has been commissioner since July 1. Lawmakers grilled him over the cabinet’s oversight of the managed care companies.

Doctors, hospitals, health departments and dentists have complained throughotu the year about cumbersome procedures and delayed payments from the managed care companies.

Co-Chair of the Health and Welfare Committee Sen. Julie Denton, R-Louisville, quizzed Kissner on why his department has seemed slow to iron out the wrinkles in the system that have had hospital administrators and doctors wringing their hands.

Their exchange is below:

The cost of Medicaid in Kentucky, which covers health care to the poor and disabled, has ballooned to well over the $6 billion dollar mark when you count federal dollars.

The goal of managed care was to hire private companies to handle the billing and approval process for medical procedures and prescriptions. The state signed contracts with three out-of-state companies in November 2011. Those private companies have an incentive to keep the costs down.

Then this fall, Kentucky Spirit announced it was breaking its contract with the state a year before it expires because it was losing money on the deal.

Kissner was asked by Rep. Julie Raque Adams, R-Louisville, what the impact would be of their decision to leave, but Kissner refused to answer because of ongoing legal proceedings with the company.

“I think it’s going to become a significant legal issue, so ramifications of that I don’t want to go into at this time,” Kissner said.


Subscribe to email updates.

Subscribe and get the latest political intelligence delivered to your inbox.