Kentucky advertises for Medicaid insurance proposals in Passport area

Kentucky advertises for Medicaid insurance proposals in Passport area

4:03 PM, Jun 20, 2012   |  
Tom Loftus
The Courier-Journal
FRANKFORT, KY. — Kentucky began the process this week of contracting with multiple companies to provide Medicaid services in the region that for the past 15 years has been served exclusively by Passport Health Plan.

On Tuesday the state began advertising for proposals from insurance companies to provide “managed care” services for Medicaid in Jefferson and 15 surrounding counties.

Bidders have until July 24 to respond.

Jill Midkiff, spokeswoman for the Kentucky Cabinet for Health and Family Services, said the state intends to select at least two companies that will begin providing Medicaid services in the region beginning Jan. 1.

Last year federal officials decided Medicaid beneficiaries in the region must be given a choice of managed care organizations. They did not extend beyond this year a waiver that has allowed Passport to be the exclusive Medicaid provider in the region.

That action came amid Kentucky’s decision last year to contract with three companies that now compete to manage health care for Medicaid recipients in Kentucky’s other 104 counties.

Mark Carter, chief executive of Passport, said it will bid to continue serving the region.

“With the track record we have, we think we’ll be able to make a very competitive proposal,” Carter said.

Because the transition to managed care in the rest of the state has been marked with complaints by providers and patients alike, some are concerned about what the pending change will mean for the 171,000 Medicaid beneficiaries in the region.

“We don’t feel that having multiple managed care contracts really supports the efforts of quality improvement and member satisfaction over time,” said Jodi Mitchell, of Kentucky Voices for Health, a health-care advocacy coalition.

Mitchell said that the federal government’s requirement of choice of managed care organizations may result in less choice of providers for Medicaid beneficiaries.

Currently a Medicaid beneficiary in the region can go to any provider because all work with Passport. “I’m not so sure that will be the same situation when you bring these for-profit companies in,” Mitchell said.

Passport was sharply criticized in late 2010 in a report by then-Auditor Crit Luallen that revealed wasteful spending and improper transfers of profits to the provider groups represented on its board. Passport responded by instituting reforms, restructuring its board and replacing all of its executives with a new team headed by Carter.

Reporter Tom Loftus can be reached at (502) 875-5136.

Denton Has Concerns About More Private Medicaid Operators in Louisville

by Kenny Colston on May 10, 2012

The problems with privatized Medicaid in Eastern and Western Kentucky could be coming to Louisville.

Passport Health Plan has run Medicaid in Louisville and the surrounding area for more than a decade. The system was the model for last year’s Medicaid privatization, which brought three new Medicaid management companies into the state.

The federal government has ordered the state to open the Passport region to competition by next year. But Medicaid privatization isn’t working too well in the rest of the state. Hospital officials claim two of the private companies aren’t paying enough to reimburse Medicaid-covered care. The private operators say they are only adhering to their contracts with the state.

“Let’s make sure we have a plan,” says Senate Health and Welfare Committee Chairwoman Julie Denton. “If we are going to be bidding out with the Passport region for next year, starting January 1st, the Cabinet sure as heck better be working on an RFP and putting it together in a more thoughtful and steady fashion than they did the Medicaid managed care RFP for last year.”

The state has until July 1 to tell the federal government its plan to open Louisville to competition. But the Cabinet for Health and Family Services hasn’t yet begun work on the plan.

The current three statewide operators all have offices in Louisville, making them obviously competition partners for the region. But Denton says she’s not sure bringing those three in is a good idea.

“I don’t think they can just take three bids from the three MCOs and open those up and let those three MCOs in. And frankly with the way Coventry has been working thus far, I have no interest in letting them into the Passport region,” she says.

Currently, many healthcare systems are having contract issues with CoventryCares, one of the three new statewide MCOs. Coventry officials say they need more operating money and the company is looking to providers and patients to recoup profits.  That has led to lawsuits and threats from lawmakers that Coventry could be barred from operating in the commonwealth.

Passport, Leadership host Chamber breakfast

by Brittany Wise – Grayson County News Gazette
03.25.12 – 12:00 pm

Representatives from Passport Health Plan, along with Leadership Grayson County hosted Thursday’s Chamber of Commerce breakfast at the Centre on Main, where a new local Passport board member was announced, along with the 2012 Leadership class and the new Executive Director of the Grayson County Chamber of Commerce.

Passport’s Chief Executive Officer, Mark B. Carter, spoke to the group about the non-profit organization’s service in central Kentucky. The group serves 16 counties, including Grayson, and provides health care for around 5,000 Grayson County residents – about 20 percent of the county’s population.

Carter explained that through the group’s partnerships with hospitals, primary care providers and a large number of specialty physicians, they are able to provide excellent quality healthcare to residents who would otherwise not have healthcare.

Carter boasted of the group’s #13 ranking among similar agencies country-wide, adding that all but two of the top 100 ranked companies were located in either New England or the West Coast, which makes Passport’s excellent slot an even more powerful accomplishment.

It was also announced that local business-owner Steven Elder has joined the Passport Health Plan Board.

Elder said of the group, “Passport Health Plan truly brings the community together. Their committee and board structures allow concerned citizens like myself to bring perspectives to the table and work collaboratively to find innovative solutions that work for everyone.”

Another exciting announcement for the Elder family was the reveal of the new Executive Director of the Grayson County Chamber of Commerce, his wife, Tara Elder.

Tara will be stepping into the shoes of former Director Caryn Lewis, who is leaving the position to work for the Grayson County School System.

Before Caryn’s departure, however, she had the opportunity to announce this year’s Leadership Grayson County class, which includes: April Bowman, with Wilson & Muir; LaShawn Cole-Hack, with Head Start; Tara Elder, with Grayson County Chamber of Commerce; Kindra Ewing-Jones, with Grayson County Extension Office; Valerie Farris, with Elder Wealth management; Alicia Harrell, with City of Leitchfield; Lisa Jones, with Grayson County Public Library; Amanda Joyce; Jessica Kelley, with Carter Harrell State Farm; Ellis Kiper, with Rocky-K Log Homes; Harold Miller, with WRECC; Trish Niles, with Mid-Park, Inc.; Carrie Petrocelli, with Twin Lakes Home Health; Natalie Taul, with Grayson County Extension Office; and Christopher Wilborn, with United Way of Central Kentucky.


Passport employee’s award to benefit OVEC’s Head Start

By The Staff
Friday, March 23, 2012 at 3:00 am       (Updated: March 23, 3:06 am)

Marcelline Coots, one of the first individuals to be hired at Passport Health Plan in 1997, has been named the 2012 Making A Difference award winner by the Association for Community Affiliated Plans (ACAP), and that’s going to benefit the Ohio Valley Educational Cooperative’s Head Start program.

She was selected from a pool of candidates submitted by the national organization’s 57 affiliated health plans located throughout 27 states. ACAP serves more than 10 million Medicaid and CHIP members across the country.

In her honor, ACAP is presenting a $500 donation to her charity of choice, OVEC, in a ceremony Wednesday at the cooperative’s office on Alpine Drive in Shelbyville.

Coots, whose daughter attends  Christian Academy of Louisville, serves on the advisory council and community board of the OVEC.

She is the main member outreach event planner for Passport Health Plan and has participated in or planned numerous special events.

“Marcelline embodies the mission of Passport Health Plan – to improve the health and quality of life of our members,” Passport Health Plan CEO Mark B. Carter said in a press release announcing her award. “She’s done things like learn to drive a truck for some of Passport’s large outreach events. That’s the kind of commitment that Marcelline has demonstrated every day during the length of her service here, and I’m delighted that she is being recognized in this manner.”


Passport Health Plan Appoints New Medical Director

Dr. James Mumford hired effective January 30, 2012

 February 29, 2012 Louisville, Kentucky – Passport Health Plan is pleased to announce that Dr. James Mumford has accepted the position of Medical Director effective January 30, 2012. Dr. Mumford is joining the Plan’s medical affairs team and will be responsible for improving the Plan’s quality and clinical processes. Dr. Mumford was most notably a previous surveyor for the National Committee for Quality Assurance (NCQA).

Dr. Mumford is also a seasoned pediatric executive with extensive medical management experience from McNeil Consumer Products in Fort Washington, PA; FHP health plan in Ogden, Provo and Salt Lake City, Utah; Humana in Louisville KY; United Healthgroup/AmeriChoice Health Services in Philadelphia, PA and most recently Carolina Healthcare Clinics in Union, South Carolina. He has also served as a pediatrician in Hazard, KY.

Dr. Mumford is a published author of “How to Cut Your Children’s Medical Costs,” and received his Masters of Business Administration and MD degrees from the University of Utah. He also holds a Bachelor of Science degree in Chemistry from the University of Utah. Dr. Mumford has a lovely wife and eight children.

“We are excited to have Dr. Mumford join us. He’s an accomplished clinician and physician executive who brings a wealth of knowledge and experience, particularly related to quality health outcomes,” said Dr. Stephen Houghland, Chief Medical Officer for Passport Health Plan.

Dr. James Mumford

New Passport Medical Director Dr. James Mumford

Passport Health Plan is a unique public private partnership with the Commonwealth of Kentucky as a provider-sponsored, community-based, member-focused Medicaid health plan that serves more than 170,000 members in 16 Kentucky counties. The Plan has operated successfully over the past 14 years. The counties of service include Breckinridge, Bullitt, Carroll, Grayson, Hardin, Henry, Jefferson, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble and Washington. Passport Health Plan is sponsored by the University of Louisville Medical School Practice Association, University of Louisville Hospital, Jewish and St. Mary’s Healthcare, Norton Healthcare, and the Louisville/Jefferson County Primary Care Association, which includes the Metro Louisville Department for Health and Wellness and Louisville’s two federally qualified health centers, Family Health Centers and Park DuValle. For additional information, please visit


Walgreens Launches Smoking Cessation Program for Passport Health Plan Members in Louisville

Pharmacists trained by Kentucky Cancer Program to provide education, support and follow-up to help smokers through cessation process

DEERFIELD, Ill., Feb 21, 2012 (BUSINESS WIRE) — Walgreens /quotes/zigman/245520/quotes/nls/wag WAG +0.43% /quotes/zigman/245520/quotes/nls/wag WAG +0.43% pharmacists at eight of the drugstore chain’s convenient Louisville locations are partnering with Passport Health Plan, a local Medicaid health plan, on a new smoking cessation program which launched in early January 2012. The program is free to Walgreens customers and Passport members and aims to improve the community’s health by giving smokers the tools, resources and ongoing clinical pharmacist counseling to help achieve their cessation goals.

Participating Walgreens pharmacists and technicians have undergone specialized training provided by the Kentucky Cancer Program at the University of Louisville’s James Graham Brown Cancer Center. The program provides further education on tobacco treatment, and helped in the development of Walgreens formal, 12-month process for helping those interested in tobacco cessation.

“The harmful effects of tobacco use are well-documented, and by working closely with our community pharmacists who people know and trust, we hope to encourage more smokers under Passport Health Plan to improve their health through this free program to help them quit,” said Greg Baker, Walgreens pharmacy supervisor for Louisville. “The cessation process can be very challenging. We believe the ongoing dialogue with pharmacists, who are among the most accessible health care professionals in the community, can be an effective tool in working with and supporting people to overcome those challenges.”

“Smoking and tobacco use are complex problems that require different approaches to adequately address,” said Stephen Houghland, M.D., chief medical officer for Passport Health Plan. “We believe that addressing this critical driver of negative health outcomes in as many areas where our members are, and with people they trust, is a great opportunity to truly make a difference in their health and quality of life.”

Passport Health Plan members identified as tobacco users can enroll by visiting one of the eight participating Walgreens pharmacy locations. Upon enrollment, pharmacists will work with patients through a multi-step process that includes:

— Information and education on smoking cessation

— Cessation options and tools, products and therapies

— Regularly-scheduled patient follow up for the next 12 months

The program is now offered at the following Louisville Walgreens stores:

— 3421 W. Broadway

— 3980 Dixie Highway

— 1475 Dixie Highway

— 700 Algonquin Parkway

— 200 E. Broadway

— 1008 N. Mulberry St.

— 1602 N. Dixie Highway

— 550 W. Dixie Highway

Walgreens will be sharing program results with Passport Health Plan on a monthly basis and will also be measuring the program’s effectiveness for individuals enrolled over a six- and 12-month period.

“We applaud Walgreens for stepping up to help patients in two districts of Kentucky and Southern Indiana end tobacco use, in this pilot initiative,” said Celeste T. Worth, Professional Education and Training Manager at the Kentucky Cancer Program. “We are pleased to work with Walgreens pharmacies in their efforts to help customers get the medications and counseling they need to successfully overcome nicotine addiction.”

About Walgreens

Walgreens ( ) is the nation’s largest drugstore chain with fiscal 2011 sales of $72 billion. The company operates 7,830 drugstores in all 50 states, the District of Columbia and Puerto Rico. Each day, Walgreens provides nearly 6 million customers the most convenient, multichannel access to consumer goods and services and trusted, cost-effective pharmacy, health and wellness services and advice in communities across America. Walgreens scope of pharmacy service includes retail, specialty, infusion, medical facility and mail service, along with respiratory services. These services improve health outcomes and lower costs for payers including employers, managed care organizations, health systems, pharmacy benefit managers and the public sector. Take Care Health Systems is a Walgreens subsidiary that is the largest and most comprehensive manager of worksite health and wellness centers and in-store convenient care clinics, with more than 700 locations throughout the country.

About Passport Health Plan

Passport Health Plan is a unique public-private partnership with the Commonwealth of Kentucky and a provider-sponsored, Medicaid health plan serving more than 170,000 members in 16 Kentucky counties. The Plan has operated successfully over the past 14 years. The counties of service include Breckinridge, Bullitt, Carroll, Grayson, Hardin, Henry, Jefferson, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble and Washington. Passport Health Plan is sponsored by the University of Louisville Medical School Practice Association, University of Louisville Hospital, Jewish and St. Mary’s Healthcare, Norton Healthcare, and the Louisville/Jefferson County Primary Care Association, which includes the Metro Louisville Department for Health and Wellness and Louisville’s two federally qualified health centers, Family Health Centers and Park DuValle. For additional information, please visit .

About the Kentucky Cancer Program (KCP)

Their mission is to promote education, research and service programs to reduce the heavy burden of cancer in our state. KCP is recognized nationally as a unique program that is state-funded, university-affiliated, and community-based. KCP is the state-mandated cancer control program, jointly administered by the University of Louisville and the University of Kentucky. For more information, contact (502) 852-6318 or visit the Kentucky Cancer Program online at .

SOURCE: Walgreens

To view this article in its original context, please visit:




Physician praises Passport

By Special to The Sun
Tuesday, February 14, 2012 at 2:31 pm

When I started practicing medicine in Bardstown almost 35 years ago, I was optimistic about my opportunity to make sick children well and to watch healthy children grow into strong adults.

Even though I started out with a slightly naïve view, I’m very proud to say I’ve had a hand in caring for thousands of Kentucky’s children. I made a commitment to serve Medicaid patients at the very beginning of my career, but I was not enthusiastic when managed care arrived in 1997.

Both my staff and the staff at Passport Health Plan will attest to my reservations during the start up. On one hand, I was right to be cautious; there were administrative and technology issues that created burdens on my practice.

On the other hand, Passport worked hard to fix what wasn’t working so doctors could focus on providing patient care. But, the gap between where we were with Medicaid managed care then and where we are now is enormous. Several recent articles point out that the state’s attempt to save money by introducing three other Medicaid managed care plans outside the Passport region isn’t going well. Maybe it was too much too soon.

My practice, Physicians to Children and Adolescents, serves over 4,700 patients on Medicaid.  Because of our locations in Bardstown and Springfield, some are covered by Passport, some by the other plans.

I’m not a managed care expert, but my staff and I see and experience the differences daily.
I suspect part of the difference is that Passport is a nonprofit and therefore never has to put the expectations of shareholders before the needs of members.

I’ve been impressed enough with Passport’s commitment to the Commonwealth to accept an offer to join their Board of directors.  From this vantage point, I’ve been able to confirm what I have long suspected: Passport Health Plan has a strong and engaged provider network, and an intense focus on delivering services at a cost that doesn’t diminish quality. In fact, engaging with providers is one of the hallmarks of Passport’s remarkable success.

I feel that Passport’s effectiveness, including their impressive clinical outcomes, are directly due to physicians and other health professionals (from throughout the service area) sitting  at the table making key decisions and sharing sacrifices for the good of the plan and the members.

The National Committee on Quality Assurance recently ranked Passport as the 13th best Medicaid plan in America, which could not have been accomplished without an invested provider network and a top-notch staff. As a member of the board of directors, I want to say Passport stands willing and ready to help the state get Medicaid back on track.

In addition to Jefferson, the plan has been successfully serving 15 rural counties for 14 years and respects and understands their unique needs.  Claims are paid on time, and members have access to the doctors, pharmacies, hospitals and specialists.

Passport is a strong and cost effective Medicaid plan that could be easily replicated throughout the Commonwealth.


Dr. James Hedrick, MD, practices pediatrics in Bardstown and received his medical degree from the University of Chicago, Pritzker School of Medicine in Chicago, Ill.


To view this article by Dr. James Hedrick, MD for The Springfield Sun please visit

House panel backs adult abuse registry bill

FRANKFORT, KY.— The House Health and Welfare Committee passed a bill Thursday to create an adult abuse registry, something long sought by advocates as a way to better protect elderly and vulnerable adults.

House Bill 259, sponsored by Rep. Ruth Ann Palumbo, D-Lexington, won unanimous approval and now goes to the full House, which passed a similar measure last year. It failed to pass the Senate.

HB 259 would create a registry similar to the existing child abuse registry, where adults found to have abused or neglected children are listed. People on that registry are barred from working in positions around children, such as at day care centers.

An adult abuse registry could be used by prospective employers, such as home health or personal care agencies, that hire people to care for adults. Employers could check the registry to determine whether an individual had been found to have abused, neglect or exploited an elderly or vulnerable adult.

Gov. Steve Beshear made the creation of such a registry a priority in his budget address earlier this month and proposes including $2.2 million over the next two years to develop and operate the registry within the Cabinet for Health and Family Services.

Also on Thursday, the committee heard from a Lexington-based home health care agency that reported significant problems under the state’s new managed care system for Medicaid that took effect Nov. 1.

Representatives of Nurses Registry and Home Health, which provides Medicaid-funded home-health services for elderly people and disabled children, said they have been confronted by major problems in filing claims, getting services authorized and getting payment under the new system in which the state relies on three private companies to handle Medicaid services.

Pat Hagan, who manages children’s services for the nursing agency that serves patients in 16 counties, said many claims aren’t getting paid and she’s concerned about how long the agency can keep serving severely disabled children.

“A lot of children depend on what we do,” she said.

The agency is one of several providers that have approached lawmakers during the session to report problems with the new managed care system, which serves about 560,000 Medicaid members outside the Louisville region. Passport Health Plan, a separate non-profit manages care company, serves about 170,000 Medicaid members in Jefferson and 15 surrounding counties.

No representatives of the three managed care companies spoke at Thursday’s hearing.

Committee chairman Tom Burch, D-Louisville, said the committee may take the matter up next week if the problems aren’t resolved.

To view this article by Deborah Yetter for The Courier-Journal please visit