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Managed Care Disconnect

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State Representative John Will Stacy says there’s a disconnect between what constituents and health care providers are telling him about Kentucky’s Medicaid Managed Care program and information supplied by the state’s Department of Medicaid Services. The West Liberty Democrat made the observation at a hearing in Frankfort last week, a day after he attended a forum in Morehead on the financial challenges facing rural hospitals.

Stacy says he rarely hears anything good about managed care…

Kentucky’s Commissioner of Medicaid Services concedes the implementation of managed care could have been handled better. However, Larry Kissner says the Commonwealth needed to save more than a billion dollars annually on Medicaid and switching from a fee for service to managed care was a way to do that…

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Kissner says claims under Medicaid Managed Care are denied about eight percent of the time compared to less than one percent when Kentucky had a fee for service system. He’s quick to add there’s an appeals process for claims that are rejected under managed care.