Ky. Spirit may have to repay Medicaid expenses
Jun 04, 2013 | 2180 views | 0 0 comments | 374 374 recommendations | email to a friend | print
By Alan Reed

Tribune-Courier News Editor

areed@tribunecourier.com

The first of a long series of court battles between the state and a Medicaid health plan has given the Marshall County Health department optimism to recover some expenses.

A Franklin Circuit Court ruled Friday that Kentucky Spirit must reimburse health departments for Medicaid-covered care given in schools.

The owned by St. Louis-based Centene Corp., was contracted by the state to provide reimbursement for low-income patients covered by Medicare.

Cathy Thompson, financial administrator for the Marshall County Health Department, said Kentucky Spirit owes the department about $113,000 in total for preventative healthcare services.

The company claimed the state was deceptive when bidding the contracts and it was losing money. It stopped making payments to health care providers in November and announced its withdrawal from the contract effective July 13, a year ahead of its scheduled termination date in July 2014.

“It looks like the schools won the first round, but Kentucky Spirit has until June 28 to file an appeal,” said Lisetta Whitworth, director of the Marshall County Health Department.

Whitworth said the order requires Kentucky Spirit to pay $7.3 million to the Cabinet for Health and Family Services for the school obligation.

“It’s not just us that they owe,” Whitworth said of the debt to Marshall County. “They owe every Medicaid health care provider.

Judge-Executive Mike Miller said other health departments are seeking reimbursement through litigation.

“If you’ve done business with Kentucky Spirit as a doctor’s office, hospital or health department, Kentucky Spirit owes you money,” County Attorney Jeff Edwards said.

Dr. Joe Ellis, a Benton optometrist and member of the Board of Health, said he expected some of the money owed to the health department to be paid. He did not know if a court would order the full amount to be repaid.

The news site Cincinnati.com reported that Kentucky Spirit’s parent company released a statement Tuesday after the ruling saying, “We are reviewing the order and considering all options including an appeal.”
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