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Lawmakers Looking for More Improvement in Medicaid Organizations

Rep. Fitz Steele (left) & House Speaker Greg Stumbo - Photo by LRC Public Information
Rep. Fitz Steele (left) & House Speaker Greg Stumbo - Photo by LRC Public Information

FRANKFORT, Ky. - Kentucky lawmakers continue to chastise three of the state’s Medicaid Managed Care organizations for mismanagement.Representatives of Kentucky Spirit, Wellcare of Kentucky and Coventry Cares appeared before the Program Review and Investigations Committee Monday. Legislators wanted to know whether they had solved problems brought up by health care providers in a January committee meeting.

The MCOs all said the problems were mostly solved and that operations were improving every day. But independent pharmacists and mental health care providers disagreed.

“As we’ve heard from our constituents, who’ve sat in here for 3 months, it’s not better. I listen to those people. Those people hire me, they send me up here to represent and that’s what I’m going to do. We need answers, we need you to move, quit dragging your feet, it’s not got any better," said state Rep. Fitz Steele (D-Hazard).

There are several bills that are meant to help reduce the strain caused by MCOs on independent pharmacies, but those bills have hit roadblocks in the final days of the session.

As for mental health care, Auditor Adam Edelen has suggested removing that part of Medicaid care from the MCO process in order to solve their problems. But Edelen adds that there have been improvements in other areas of the process.

“My sense is that the system is getting better. My sense is the MCOs have done a better job in the last number of weeks in bringing in staff from other places to clear up backlogs but certainly work needs to be done,” Edelen said.

Edelen expects to finish an audit of the MCOs by early 2013. Until then, lawmakers warned the organizations to start addressing the numerous other concerns raised.