State Auditor Adam Edelen has released ten recommendations for a more efficient Medicaid Managed Care system in Kentucky. For weeks, the MCOs, lawmakers, health care providers and patients have tussled over the new system, which was implemented quickly to plug a budget gap.
MCOs have promised lawmakers that the majority of problems are fixed, but some areas like pharmacy and mental health, are still having issues.
Rather than directly auditing the managed care organizations, Edelen instead looked into how the system was using taxpayer’s funds. <!--more-->
The auditor expressed concern that only half of the more than seven hundred million dollars the state has paid the MCOs has been paid back out to health care providers.
The majority of Edelen’s recommendations include updating or getting universal software systems for all parties to use. He also suggests the Cabinet for Health and Family Services should play a tighter oversight role.
Edelen says he will create a new Medicaid Accountability and Transparency Unit in his office to help continually oversee the Medicaid system.