Politics & Government

Beshear may veto bill that would push for quicker Medicaid reimbursements


FRANKFORT — A bill designed to help doctors, hospitals and other medical providers receive prompt payments from the state's Medicaid managed care companies awaits Gov. Steve Beshear's signature or veto.

Despite passing both the state House and Senate unanimously and having the support of the medical community, Beshear has left open the possibility he may veto House Bill 5 because of concerns that it could cost too much to implement.

If Beshear opts to veto House Bill 5, the veto will stand because the legislature gave final passage to the bill on one of the last days of the 30-day legislative session. They cannot come back and override the veto.

"I haven't made any decisions on (HB 5)," Beshear said last week at a press conference on an unrelated topic. Beshear said his staff have expressed reservations that the bill may be too costly to implement.

House Speaker Greg Stumbo, who sponsored HB 5, has warned that if Beshear vetoes the bill, it will likely be filed again in 2014.

"If it's not addressed, I guarantee you it's going to be House Bill 1," Stumbo said last week.

House Bill 5 would allow the Department of Insurance to mediate disputes between health care providers and the three private managed care companies that serve more than 500,000 Medicaid patients. Health care providers — particularly hospitals — have repeatedly complained that they are not being paid promptly by the managed care companies hired by the state in November 2011 to manage costs in the federal and state health care program for the poor.

The Kentucky Department of Insurance oversees the state's prompt pay statutes for private insurance companies but does not regulate Medicaid managed care companies. Under House Bill 5, Department of Insurance would be able to impose penalties if the managed care companies violate the prompt pay statutes.

But after the House unanimously approved HB 5 on Feb. 27, the Cabinet for Health and Family Services and the Kentucky Department of Insurance told legislators that it could cost an "indeterminate" amount to implement House Bill 5. According to a fiscal note attached to the bill on March 1, the cabinet and the department of insurance said that they may have to add more staff to handle all of the complaints.

Stumbo said that the cabinet at first said HB 5 would not cost additional money because its officials maintained that there was not a backlog of disputed claims. Now, the cabinet is finally admitting that there are a lot of disputes between providers and the managed care companies, Stumbo said.

He said last week that expects Beshear to veto the bill.

"It will cause harm," Stumbo said if Beshear vetoes the bill and providers do not get some relief.