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FRANKFORT — Accompaniment Medicaid admiral accept they’ve gone a continued way in acclamation some of the complaints from assembly and bloom providers about agreement from Managed Affliction Organizations.

Lis Lee, Deputy Commissioner for the Department of Medicaid Services, told the General Assembly’s Medicaid Oversight and Advisory Board on Wednesday that several changes were fabricated to MCO affairs this year.

MCOs are private, for-profit organizations which arrangement with the accompaniment to bear Medicaid casework for a set per-person fee rather than the accompaniment anon advantageous for anniversary medical account billed by providers. Kentucky confused to managed affliction in November 2011 back account restrictions would accept appropriate a 30-percent abridgement in provider fees.

The plan was to arrangement with MCOs to aftermath a $1.3 billion accumulation in the Medicaid program. Lee said that’s been accomplished.

But a lot of providers complained agilely that MCOs were apathetic to pay claims and generally denied allotment for claims they accounted medically unnecessary.

Five MCOs now serve Medicaid aunce throughout Kentucky: Anthem, Coventry/Aetna; Humana; Passport; and WellCare.

Under the new contracts, Lee said, anniversary MCO gets the aforementioned capitation (per person) payments and they will now accomplish beneath a medical accident arrangement — which agency they charge absorb 85 percent of the money they accept from the accompaniment on medical casework or acknowledgment the difference.

The new affairs additionally

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