Health and Family Services Cabinet
Kentucky Receives Federal Approval to Implement Medicaid Managed Care
The Kentucky Cabinet for Health and Family Services (CHFS) has received approval from the Centers for Medicaid and Medicare Services (CMS) to operate a Medicaid managed care organization waiver program. The waiver allows Kentucky to implement a mandatory managed care program for virtually all Medicaid recipients in the state outside of the Passport region, which operates under a separate CMS waiver.
“This approval is a milestone for our new managed care system, and shows that CMS has confidence in our process. We remain focused on facilitating the transition from an unmanaged care delivery system to coordinated care for Medicaid recipients,” said CHFS Secretary Janie Miller.
In July, Governor Steve Beshear announced that Kentucky had awarded four contracts to managed care organizations (MCOs) to provide health care services to Medicaid recipients statewide. Three of those contracts are with new vendors. Coventry Cares of Kentucky, Kentucky Spirit Health Plan and WellCare of Kentucky will serve more than 560,000 recipients across the state that live outside the 16-county region served by Passport, which provides managed care to 170,000 Medicaid recipients.
The expansion of Medicaid managed care to cover the entire state required federal approval from CMS, which the state received on Sept. 8, 2011. The move to statewide managed health care will save taxpayers $375 million in General Funds and $1.3 billion in all funds over the course of the new, three-year contracts.
The approval letter from CMS indicates its decision to approve Kentucky’s request “is based on evidence submitted to CMS demonstrating the state’s proposal is consistent with the purposes of the Medicaid program, will meet all of the statutory and regulatory requirements for assuring beneficiaries’ access to and quality of services and will be a cost-effective means of providing Medicaid services to Medicaid recipients in Kentucky.”
The waiver approval is effective for the period of Oct. 1, 2011 through Sept. 30, 2013.