We’ve been hearing from insiders for months that Kentucky’s new Medicaid managed care system is teetering.

But the Herald-Leader beat us to the punch yesterday with a hugely important story that details a lot of what we’ve heard  about care providers getting little in the way of reimbursements since the November 1 switchover from fees-for services.

Reporter Beth Musgrave’s story cites multiple providers saying the managed care companies – Coventry Cares, Wellcare of Kentucky and Kentucky Spirit – are months behind.

Musgrave includes in the story therapists who work with abused, neglected and at-risk children telling legislators they might have to close their doors if they don’t receive back payments soon.

Coventry Health Care, Inc. based in Bethesda, Md. denied the most claims and gets the most criticism from people interviewed for the story.

The Herald-Leader isn’t the first Kentucky newspaper to cover this story, but this is the best reporting so far.

Months ago, when Insider Louisville broke this story, multiple insiders predicted disaster, with one saying, “This is a poorly planned change that’s being implement too quickly.”

That said, the Herald-Leader did not list any problems with Louisville-based Passport Health Plan, which oversees 17 counties around Jefferson County.

Insiders told Insider Louisville back in April the switch to managed care from fee-for-services was being rushed as Gov. Steve Beshear tried to push past Passport’s 2010 spending and conflicts of interest fiasco while dealing with Kentucky’s Medicaid deficit.

At the time,  Beshear touted the switch to managed care from fee-for-services as saving the state $375 million over the life of the initial three-year contracts.

Insiders told us then that in other states such as Georgia took as long as 18 months to make the change while Kentucky tried to do it in less than six months.

More as we work our sources.

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Terry Boyd
Terry Boyd has seven years experience as a business/finance journalist, and eight years a military reporter with European Stars and Stripes. As a banking and finance reporter at Business First, Boyd dealt directly with the most influential executives and financiers in Louisville.

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