KVH Thanks Governor for Support of Medicaid, Shares Principles for Medicaid Managed Care

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May 9th, 2011

KVH Thanks Governor for Support of Medicaid, Shares Principles for Medicaid Managed Care

Kentucky Voices for Health sent a letter of appreciation today to Governor Steve Beshear for joining 16 other governors in expressing opposition to a block grant for federal Medicaid spending.

KVH agrees, as the governors’ April 4, 2011 letter to Congressional leaders noted, that the proposed Medicaid block grant would shift costs to states and severely undercut the state's ability to provide care to Kentuckians and adequately pay providers.

As Kentucky is also moving forward with efforts to expand Medicaid managed care, KVH shared with the governor a set of principles that the organization believes should guide its implementation:

1.    Kentuckians should have access to high-quality, affordable, effective health care regardless of poverty status or disability.

2.    To ensure a health care program that is responsive and accountable to the public, the state should require managed care plans to implement consumer involvement, representation, and protections; including adequate appeal rights for denial of services.

3. Managed care plans should cover prevention and early intervention, emphasize a recovery orientation, and provide for health education and promotion of healthy lifestyles.

4.    The state should engage in vigorous oversight and management to assure the highest quality of care; eliminate waste, fraud, and abuse; and achieve administrative efficiency at all levels.

5.    Implementation of cost-containment and cost-sharing measures should be grounded in evidence-based practices and should not create a barrier for individuals to access necessary care.

6.    Provider rates should be set appropriately to assure participation and access.

7.    Provider networks must be sufficient in number, distribution, and variety of health care professionals to serve Kentuckians in the Medicaid program in a timely and convenient manner.

8.    The health care program should be comprehensive in benefit structure and promote the integration of mental, dental and vision care with physical health care to meet all of the health needs of Kentuckians in the Medicaid program.

9.    Administrative costs should be limited in a manner similar to the Medical Loss Ratios required by the Affordable Care Act to ensure that funds for the provision of services will not be unnecessarily diverted to profits for managed care plans.

10.         The state should require transparent record keeping affording the public easy access to key information about the cost and quantity of services provided in each Kentucky county, utilization trends, quality indicators, patient satisfaction and health care outcomes.

11.         All contractors receiving state funds to administer Medicaid managed care programs should be required to comply with the Kentucky Open Records Act.

Read KVH’s full letter to Governor Beshear here.

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