Commonwealth of Kentucky
Cabinet for Health and Family Services
FOR IMMEDIATE RELEASE
Contact: Jill Midkiff
502-564-7042
502-330-1185
Medicaid Managed Care Contracts Awarded for Jefferson and
Surrounding Counties
Coventry Cares, Humana, Passport and Wellcare will provide coverage beginning in 2013
FRANKFORT, Ky. (Oct. 4, 2012) – The Commonwealth of Kentucky has signed contracts with
four managed care partners to provide health care services to approximately 175,000 Medicaid
recipients in Louisville and 15 surrounding counties. These managed care organizations
(MCOs) will provide services in Region 3, which is comprised of Breckinridge, Bullitt, Carroll,
Grayson, Hardin, Henry, Jefferson, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer,
Trimble and Washington counties.
The four MCOs awarded contracts for Region 3 are Coventry Cares, Humana, Passport and
Wellcare of Kentucky. The contracts are for an initial 18 months with four, one-year renewal
options. The new contracts will take effect Jan. 1, 2013.
Earlier this year, the Centers for Medicaid and Medicare Services (CMS) advised the Cabinet
that Region 3 could no longer operate with a single managed care provider. Beginning Jan. 1,
2013, CMS requires that Medicaid recipients in Region 3 have a choice of more than one
provider for health care services.
“The managed care approach is familiar to Medicaid recipients in the Jefferson County area, but
having a choice of managed care organizations is new,” said Cabinet for Health and Family
Services Secretary Audrey Tayse Haynes. “Passport has been a good partner and has served
the region’s recipients well for 15 years, but the federal government now requires that
individuals have a choice of providers. The Cabinet is pleased with the level of interest from the
managed care community and we look forward to their work on behalf of our Department for
Medicaid Services and the individuals who rely on Medicaid for their health care coverage.”
The Cabinet for Health and Family Service’s Department for Medicaid Services has contracted
with Passport to be the sole provider of Medicaid-covered services in Region 3 since
1997. Medicaid recipients in the remaining 104 counties in the Commonwealth have a choice of
three MCOs that have been providing managed care services since Nov. 1, 2011.
Over the last four fiscal years, the Medicaid cost for Passport members was reduced 6.5
percent even though health care costs in the southern region of the United States have
increased an average of nearly 3.5 percent. The new contracts maintain those savings for the
biennium, and protect the Medicaid program against rising health care costs over the next 18
months.
The new contracts will include behavioral health services, as is the case in Medicaid managed
care contracts for the rest of the state.
Medicaid recipients and providers in Region 3 will soon receive a letter about these changes.
The Department for Medicaid Services will enroll Medicaid recipients in Region 3 with the MCO
that is determined by a high-tech matching system to be the best fit based upon available
provider networks and any special health care needs the individuals may have. Members will
receive notice by early November of the MCO with which they have been matched. Upon notice
of this match, Medicaid recipients will have 30 days to select a different MCO before the Jan. 1,
2013 effective date of coverage. The Department for Medicaid services will provide information
about how Medicaid recipients can choose the best MCO for their needs. Medicaid recipients
who wish to switch to a different MCO after Jan. 1, 2013, will have another 90 days in which to
request a change.
As required by state procurement law, the Cabinet solicited proposals from managed care
companies interested in offering services in Region 3 beginning Jan. 1, 2013. The RFP was
issued on June 19, 2012 and contracts with vendors were finalized today.
-30The Cabinet for Health and Family Services is home to most of the state's human services and
health care programs, including Medicaid, the Department for Community Based Services and
the Department for Public Health. CHFS is one of the largest agencies in state government, with
nearly 8,000 full and part-time employees throughout the Commonwealth focused on improving
the lives and health of Kentuckians.