Passport Removed as State Medicaid Provider

FRANKFORT, Ky. – The Department for Medicaid Services has denied Passport Health Plan’s request for a proposal for a state contract to be a managed care organization.

The Cabinet for Health and Family Services made the announcement Wednesday that Passport will no longer be an MCO.

This comes after a contentious year between the state and the Medicaid provider who in March said they were close to becoming insolvent as a result of changes to the Medicaid reimbursement rates in the Louisville area. The non-profit said they were the only MCO that saw their rates changed and questioned if the Bevin Administration was targeting them. The state, however, argued many of the MCOs financial troubles could be solved by lowering some of their administrative costs and enacting other cost-saving measures.

Passport’s financial problems seemed to be solved with Evolent Health announcing they would be purchasing the non-profit in late July, the relationship between the MCO and the state did not get any better, however. Passport declined a request for an appearance at a September Medicaid Oversight and Advisory Committee saying they were in the middle of the RFP process and was advised by counsel to not appear before the committee. The Republican-led legislature voiced their opposition to the MCO citing problems constituents have had with the provider.

As for the development of the new site an 18th and Broadway in West Louisville Passport says they believe it will have a positive impact on the community

“A search is under way to identify a developer that can bring the vision for the site to fruition. However, our immediate efforts are focused on mounting a successful protest to the state contract awards so that we can continue to serve our members across the Commonwealth,” Adkins said.

“We are deeply disappointed in this decision, having been a committed partner to the state and an organization that has been dedicated to improving Kentuckians’ health and wellbeing for more than 20 years, with demonstrable results,” said Passport Chief Executive Officer Scott Bowers. “We intend to protest the state’s decision with the goal of continuing to provide Medicaid benefits and improve the health and quality of life of our members throughout the Commonwealth.”

The companies awarded a state contract are:

  • Aetna Better Health of Kentucky 
  • Humana Health Plan, Inc.
  • Molina Healthcare of Kentucky 
  • UnitedHealthcare DBA UnitedHealthcare Community Plan of Kentucky
  • WellCare Health Insurance of Kentucky 

Each will serve the approximately 1.3 million Medicaid beneficiaries beginning July 1, 2020.

WellCare has been chosen to serve all children in foster care in Kentucky including some children who have been adopted out of foster care, children in the Department of Juvenile Justice system will also be covered under WellCare. The Medicaid program will be called Supporting Kentucky Youth.

The cabinet says the new MCO contracts include improved performance measures, increase focus on quality care, require more transparency for state agencies into the MCO operations, among other things.

Passport says if the decision is upheld it will have a “profound” impact on the 300,000 members and 600 employees.

“We strongly encourage state leaders to reconsider this decision and its devastating impact on our proud Kentucky company and the communities we serve. We fully intend to protest the state’s decision so that we may continue to deliver better health outcomes to Medicaid members throughout the Commonwealth,” Spokesperson Ben Adkins said.

The contracts also make several improvements to the management of pharmacy benefits, including a prohibition on spread pricing for pharmacy benefit managers (PBMs), and protections in contracting for pharmacists in the Commonwealth.

MCO contracts are for five years.