Ky. hospital chain takes Medicaid dispute to court

from the Washington Examiner

May 02, 2012 — 11:05 AM
The Associated Press

FRANKFORT, Ky. (AP) — An eastern Kentucky hospital chain has asked a federal judge to intervene in a dispute with one of three companies the state picked to administer Medicaid when it changed the program last year.

Attorneys for Appalachian Regional Healthcare say patient care will be disrupted and workers will be laid off unless the judge issues an emergency order forcing Coventry Cares to allow its members to continue receiving care at its facilities. The Lexington Herald-Leader ( reports attorneys filed a request Tuesday seeking the injunction against Coventry.

If Coventry terminates its contract with Appalachian Regional Healthcare on Friday, it would affect about 25,000 people in the state’s poorest region. The healthcare system includes eight hospitals and several clinics and home-health agencies.

The state decided last year to switch Medicaid to a managed-care program as a way to save money, but problems have arisen during its implementation. Coventry was one of three companies the state chose to manage health care services for Medicaid patients in most of the state.

Coventry has said it needs to pull out of the contract because of decisions made by the state. The company said in court papers that another Medicaid contractor was allowed to not include ARH in its network, which meant it got more high-risk and high-cost patients. It also said that the state doesn’t effectively assess risks to assure managed care providers with more high-risk patients are adequately compensated.

Jill Midkiff, spokeswoman for the Cabinet for Health and Family Services, said the contractors agreed to the state’s risk-adjustment plan when it bid to become a provider.

Rick King, chief legal officer for the hospital chain, says patients are facing long travel times to get to other facilities approved by Coventry.

“We’re talking about 25,000 or more people who are going to be scrambling around trying to find health care in places where they’ve never been, trying to buy gas that they can’t afford,” King said Tuesday at a public meeting over the issue in Harlan.

ARH spokeswoman Hollie Harris said it would also mean job cuts of up to 400 workers.

“This is an issue that is going to have a devastating impact on southeastern Kentucky,” said Dan Stone, CEO of the ARH hospital in Harlan.

Coventry spokesman Matthew Eyles said the company would continue coverage for a few ARH patients, including some pregnant women, some cancer patients and follow-up appointments for people who have had recent surgeries.

Kerri Richardson, spokeswoman for Gov. Steve Beshear, said he is aware of the dispute, and that state officials have encouraged Coventry and ARH to continue talks.