TheTimesTribune.com, Corbin, KY

State News

June 25, 2013

State health departments could get payment

CORBIN — By Ronnie Ellis / CNHI News Service

Kentucky’s health departments may soon be getting some money to back up an earlier court ruling that one of the state’s Medicaid managed care organizations must pay for treatments provided by school nurses.

On Monday Franklin Circuit Judge Phil Shepherd told attorneys for the Cabinet for Health and Family Services and Kentucky Spirit, the Managed Care Organization (MCO), he is “inclined” to order the state to pay the health departments out of money it is withholding from Kentucky Spirit.

In May, Shepherd ruled Kentucky Spirit must pay $7.9 million for the school services provided by local health departments. The state has been withholding payment to the MCO until it complies and was in court Monday on a motion to compel Kentucky Spirit to post bonds to cover the disputed payments while Kentucky Spirit appeals the May ruling.

“I would rather allow (the state to make the payments) than to post additional bonds,” Shepherd said after the state’s attorney, Richard Sullivan, said such an order would “be helpful” in securing federal Medicaid approval.

But Shepherd said the commonwealth would make the payment at its own risk. If Kentucky Spirit wins an appeal of Shepherd’s earlier ruling, it would be the state, rather than local health departments, which would have to refund the money.

Before Kentucky moved to a managed care delivery system for Medicaid, it paid health departments for the school nurse services. The other MCOs have made payments for the school nurse services but Kentucky Spirit objected to paying for the services because the nurses aren’t under direct, immediate supervision by a doctor.

When he issued his May ruling, Shepherd said the nurses work under doctor supervision even if the doctor is not present in the school building when the treatment is provided.

Kentucky Spirit is also attempting to break its contract with the state and cease operations in Kentucky, claiming the state under estimated costs of delivering services to Medicaid clients.

In another health care-related suit, Shepherd set a July 25 date to hear arguments in a suit filed by David Adams, a tea party activist, who claims Gov. Steve Beshear did not have the authority to establish a Health Benefit Exchange.

The exchange is an online website where individuals and some small businesses can shop for affordable health insurance.

The Beshear administration sought to have the case dismissed, but Shepherd ruled Adams has standing as a taxpayer to pursue the case. Adams’ attorney, Michael Dean, has filed a motion for a summary judgment in favor of Adams.

Beshear re-issued in amended form his original executive order establishing the exchange and Adams claims that isn’t legal. But Shepherd said the re-issued order does not substantively alter the arguments about a summary judgment.

Shepherd will allow attorneys for the state to respond to the motion and hear arguments on July 25.

RONNIE ELLIS writes for CNHI News Service and is based in Frankfort. Reach him at rellis@cnhi.com. Follow CNHI News Service stories on Twitter at www.twitter.com/cnhifrankfort.

1
Text Only
State News
  • Healthcare signup in state extended

    While the national health exchange established by the Affordable Care Act — known to some as Obamacare — suffered glitches, crashes and delays, the Kentucky-run exchange, Kynect, was often used as a national model.

    April 4, 2014

  • Kentucky budget passed with little debate

    The Kentucky General Assembly, divided between chambers along party lines, overwhelmingly passed a $20-billion, new two-year budget not only on time but with almost no debate.

    April 1, 2014

  • Lawmakers agree on snow bill

    Kentucky school officials, parents and students finally have what they’ve been asking for: A bill to allow them to get out of school before the summer fully sets in, even if they don’t make up some of the days they missed during the severe winter.

    March 31, 2014

  • Tensions rise during budget negotiations

    Tensions increased Friday between the Republican Senate and Democratic House over continuing negotiations on a new, two-year budget. It even got personal at times.

    March 31, 2014

  • Kentucky Power plan a potential landscape-changer

    Electrical ratepayers, local governments and those employed in the coal industry might have a hard time understanding the complicated transaction through which Kentucky Power Company is purchasing half the generating capacity of a coal-fired West Virginia plant.

    March 28, 2014 2 Stories

  • Senate passes budget with no locked-in gas tax hikes

    The state Senate on Tuesday passed its version of a two-year revenue measure, and unlike the House version, it does not lock in gas tax increases.

    March 26, 2014

  • House passes bill aimed at saving Big Sandy Plant

    Backers of a bill to require the Kentucky Public Service Commission to “reconsider” its previous order approving Kentucky Power’s purchase of a West Virginia generator say all they are asking “is for them to take a second look and look at all the facts.”

    March 26, 2014 1 Story

  • Judge: Companies can’t use eminent domain for pipeline project

    Franklin Circuit Judge Phillip Shepherd on Tuesday ruled that companies building a natural gas liquids pipeline across parts of Kentucky cannot invoke eminent domain to force private property owners to provide easements.

    March 26, 2014

  • Still no snow day solution from lawmakers

    Senate and House negotiators, working on a bill to give school districts flexibility in making up snow days, each accused the other of moving the goal posts – but it’s the local school districts who may be penalized.

    March 25, 2014

  • Senate sets budget with ‘wiggle room’

    It was no surprise the Republican-controlled Kentucky state Senate altered the $20 billion, two-year state budget approved by the Democratic-controlled House, but there may have been a few who were surprised by how little it was changed.

    March 25, 2014

Front page
Featured Ads
AP Video
Hyperlocal Search
Premier Guide
Find a business

Walking Fingers
Maps, Menus, Store hours, Coupons, and more...
Premier Guide