FRANKFORT — Gov. Steve Beshear said Thursday that the state is working to address problems in the state's switch to Medicaid managed care and he thinks the system will ultimately work.
Beshear said moving about 560,000 poor and disabled people to three managed care companies on Nov. 1 was a huge task.
"We are obviously having some problems, but they are not really problems that we didn't necessarily expect," Beshear said. "We are being very aggressive ... at looking at these issues and resolving these issues."
Doctors, hospitals, dentists and pharmacists have complained that the three companies hired to manage Medicaid have delayed payments and taken too much time to pre-approve certain treatments and procedures. According to testimony Wednesday, some independent pharmacists have had to lay off staff, and some providers have had to get loans from banks to pay their staff because of payment delays.
Beshear said Thursday that he expects the problems within the system to be worked out soon. When Medicaid moved to managed care in Louisville in 1997, there were similar problems with providers not being paid promptly and complaints about the cumbersome pre-approval processes. Those problems were worked out, Beshear said.
Passport, which manages Medicaid in Louisville and 15 surrounding counties, was the only managed care company in Kentucky for 14 years before Nov. 1.
Beshear says the state expects to save $365 million to $375 million over the next three years by switching to managed care.
Cabinet officials told the House Health and Welfare Committee on Thursday that the cabinet plans on-site compliance reviews of Coventry Cares, Kentucky Spirit and WellCare, the three managed care companies. An on-site audit of Coventry Care has already begun, said Murray Wood, a legislative liaison with the Cabinet for Health and Family Services, which oversees Medicaid.
Wood said if the cabinet finds problems, it can demand corrective action in 15 days.
Wood said that on-site review will include looking at the company's promptness of payment and why certain claims are being denied.
Many legislators expressed frustration on Thursday.
Rep. Brent Housman, R-Paducah, said that a week does not go by without a doctor or a health care provider calling him to complain. Other legislators have also been bombarded with calls from providers, he said.
People have even stopped him in Wal-Mart to complain, he said.
"If they can't make payroll, they're going out of business," Housman said. And if those providers go out of business, some of the state's most vulnerable citizens will not receive health care that they need, he said.