Medicaid managed-care provider Kentucky Spirit pulls out of Kentucky

bmusgrave@herald-leader.comJuly 6, 2013 

  • INFORMATION

    Patients may call Coventry Cares, WellCare or Medicaid about the transition in their coverage.

    Coventry: 1-855-300-5528

    Kentucky Medicaid: 1-800-635-2570

    WellCare of Kentucky: 1-877-389-9457

FRANKFORT — More than 124,000 Medicaid patients have a new managed care provider after Kentucky Spirit quit serving its patients Saturday, state officials said.

Kentucky Spirit has been in a legal battle with the state over whether it can end its three-year contract a year early. Its patients received a letter last week notifying them that they would be transferred to two other managed care providers, Coventry Cares or WellCare, if Kentucky Spirit opted to leave the state on July 5.

Officials with the Cabinet for Health and Family Services, which oversees the state's Medicaid managed care contracts, said Kentucky Spirit stopped serving Kentucky Medicaid patients shortly after midnight Saturday.

The cabinet will now file a lawsuit accusing Kentucky Spirit of breaching its contract with the state, said Jill Midkiff, a spokeswoman for the cabinet. If successful, the state could win millions of dollars from Kentucky Spirit, a subsidiary of St. Louis-based Centene Corp.

Meanwhile, Kentucky Spirit's patients have already been assigned to either Coventry Cares or WellCare, and patients and providers are encouraged to contact the cabinet, Coventry Cares or WellCare if they have questions about the transition, Midkiff said. Patients will have up to 90 days to switch if they are not satisfied with their assigned managed-care provider, Midkiff said.

"While we are disappointed that Kentucky Spirit has defaulted on its contract with the state and abandoned its members, both Coventry Cares and WellCare have agreed to work closely with the cabinet, providers and members to make this transition as smooth as possible," Midkiff said. Officials with Kentucky Spirit were not immediately available for comment Saturday.

Kentucky contracted with the three managed-care companies in November 2011 in an effort to contain escalating costs in Medicaid, the federal and state health care program for the poor, elderly and disabled. Kentucky Spirit told the state last year that it would pull out of Kentucky a year before its contract was to expire in July 2014, citing a larger-than-expected loss of money.

In May, a Franklin Circuit Court judge ruled that if Kentucky Spirit left the state early, it would be in breach of contract.

Kentucky Spirit's appeal of that decision is pending.

Meanwhile, the cabinet asked the Kentucky Court of Appeals to block Kentucky Spirit's exit until Aug. 31. The cabinet argued the state needed more time to transition patients from Kentucky Spirit to Coventry or WellCare. The state Court of Appeals denied the request July 1, saying the cabinet had had enough time to plan for a smooth transition and could terminate Kentucky Spirit, then force it to stay for two months under the current contract.

The cabinet balked at terminating Kentucky Spirit's contract, saying that if it did so it would not be able to sue the company for breach of contract.


Information

Patients may call Coventry Cares, WellCare or Medicaid about the transition in their coverage.

Coventry: 1-855-300-5528

Kentucky Medicaid: 1-800-635-2570

WellCare of Kentucky: 1-877-389-9457

Beth Musgrave: (859) 231-3205. Twitter: @BGPolitics. Blog: bluegrasspolitics.bloginky.com

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