Information for Medicaid Providers
The state has established four contracts with managed care organizations (MCOs) to provide services to Medicaid members across Kentucky. Three of those contracts are with new vendors that will serve more than 560,000 recipients beginning Nov. 1, 2011. The Passport Health Plan, which was previously Kentucky's only managed care provider, will continue to provide services to 170,000 Medicaid recipients in Jefferson and 15 nearby counties (Breckinridge, Bullitt, Carroll, Grayson, Hardin, Henry, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble, and Washington counties).
Enrollment of Medicaid members into the new MCOs will begin in August. Each new MCO is establishing a network of health care providers to provide medically necessary services to members. Existing providers of Medicaid services may be contacted by one or more of the new MCOs about providing Medicaid services under the new plans. Medicaid encourages providers to participate in all MCO provider networks.
The three new MCOs are:
CoventryCares of Kentucky – a Medicaid product of Coventry Health and Life Insurance Company. Coventry Health and Life Insurance Company is a subsidiary of Coventry Health Care, Inc. Coventry companies currently offer Medicaid managed care services in eight states: Florida, Maryland, Michigan, Missouri, Nebraska, Pennsylvania, Virginia and West Virginia.
Kentucky Spirit Health Plan – a subsidiary of Centene Corporation headquartered in Missouri, which has 27 years of experience managing Medicaid plans, and currently provides services in 12 other states: Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Maryland, Mississippi, Ohio, South Carolina, Texas and Wisconsin.
WellCare of Kentucky – a part of WellCare Health Insurance of Illinois, which currently serves 2.2 million members in seven states: Florida, Georgia, Hawaii, Illinois, Mississippi, New York and Ohio
Contact information for each MCO can be found here or visit the Medicaid website for additional provider information. Download a letter to providers about the coming Nov. 1 implementation (Oct. 25).
Providers may also dowload: a letter and frequently asked questions document sent to providers (July 22), a question and answer document sent to hospitals (Aug. 5) or a follow-up letter and updated frequently asked questions document sent to providers (Aug. 12). Or read a news release about the one-month extension of implementation to Nov. 1 (announced Sept. 19).