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TMCNet:  Central Kentucky doctors cut ties to Medicaid provider Coventry

[December 20, 2012]

Central Kentucky doctors cut ties to Medicaid provider Coventry

Dec 20, 2012 (Lexington Herald-Leader - McClatchy-Tribune Information Services via COMTEX) -- The Physicians' Network, a group of 550 independent physicians in Central Kentucky, has announced plans to cut its ties with Medicaid provider Coventry Cares of Kentucky.

Dr. Ralph Alvarado, president of the network, which includes family care providers and specialists, said Thursday that Coventry had told the group that it would begin to pay less than the established Medicaid rate in reimbursements -- as much as 10 percent less for care from specialists.

Medicaid is the federal-state health insurance program for the poor and disabled. More than 700,000 Kentuckians receive insurance through Medicaid.

Alvarado said doctors now taking Medicaid are making a slim profit at best, and the cuts proposed by Coventry would remove even that. He said current Medicaid rates "are already abysmal." In some cases, he said, doctors would be paying to take care of Medicaid patients.

Coventry issued a statement Wednesday that said: "Coventry was notified earlier this month that The Physicians' Network intends to withdraw from our network. This decision would not take effect until March 7, and we do not expect any network access issues for our members. That said, Coventry would like our members to continue enjoying access to this group of providers. We remain committed to continuing negotiations and trying to find common ground so that we may extend our relationship with The Physicians' Network for the benefit of our members.

Alvarado said the physicians network would negotiate with Coventry, but only if Coventry increases its proposed reimbursement rate.

"We have to have at least standard Medicaid rates," he said. "You have to have enough to balance your books and be profitable." Cheryl Truman: (859)231-3202. Twitter: @CherylTruman.

___ (c)2012 the Lexington Herald-Leader (Lexington, Ky.) Visit the Lexington Herald-Leader (Lexington, Ky.) at Distributed by MCT Information Services

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