Politics & Government

Bill would streamline complaints against Medicaid companies

Greg Stumbo, D-Prestonsburg, is speaker of the Kentucky House.
Greg Stumbo, D-Prestonsburg, is speaker of the Kentucky House.

FRANKFORT — House Speaker Greg Stumbo filed legislation Thursday that would allow the Department of Insurance to settle disputes between providers and the state's Medicaid managed care companies.

Currently, the Cabinet for Health and Family Services must refer any complaints to the Department of Insurance.

Under House Bill 5, grievances about Medicaid managed care would go to the cabinet and the Department of Insurance at the same time. The bill would streamline disputes between doctors, hospitals and the managed care companies, Stumbo said.

The cabinet oversees the Medicaid managed care contracts.

"There are too many providers out there with too many complaints," Stumbo said.

Additionally, the legislation would set a six-month time limit for a Medicaid managed care company to deny payment for a claim.

The state moved more than 570,000 people to three private managed care plans in November 2011. Health care providers have complained that the managed care companies are slow to pay claims. Medicaid is a state-federal health care program for the poor and disabled.

"My bill will give the Department of Insurance, which has an extensive history of resolving disputes in the private insurance market, the ability to do the same thing when it comes to Medicaid," Stumbo said.

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