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Medicaid's move to managed care delayed until Nov. 1; hospitals need more time to sign contracts

The move to managed care, which the state has touted as the answer to improve the quality of its Medicaid system and solve a budget deficit, has been delayed by a month in response to the Kentucky Hospital Association saying hospitals need more time to sign contracts and prepare for implementation.

"We have made great progress in Medicaid managed care since we first announced the contract awards in July," said Janie Miller, secretary for the Cabinet for Health and Family Services. "Thousands of providers have signed up with the managed care organizations ... but we still need the hospitals to sign contracts before we can implement managed care across the commonwealth."

Mike Rust, president of the KHA, said of about 100 hospitals that will be affected by the changes, only about 20 have signed contracts so far, reports Deborah Yetter of The Courier-Journal.

Four managed-care organizations, including the previously established Passport Health Plan in Jefferson and surrounding counties, will take over health-care management of the state's 730,000 Medicaid recipients. The companies will be paid a per-patient, per-month amount set by contract negotiations. Because they won't be paid using a fee-for-service model — believed to be more costly — and will try to streamline care, the move is expected to save $1.3 billion in the next three years, Miller has said.

Earlier this month, Kentucky got the green light from the federal Centers for Medicaid and Medicare Services to proceed with the transition to managed care. (Read more)

Law enforcement and allies getting ducks in row in 2nd bid to pass bill to require a prescription to buy pseudoephedrine

By Tara Kaprowy
Kentucky Health News

With police finding 20 percent more meth labs in Kentucky than a year ago, they and others are again encouraging state legislators to make pseudoephedrine less available by requiring a prescription for it. And the senator who tried that last year says he is talking with his colleagues to see what can pass in the 2012 General Assembly.

Supporters of the bill to quash "meds for meth" met in Laurel County last week, where the incidence of meth labs recently became the state's highest, Bill Estep of the Lexington Herald-Leader reports. They unveiled an educational campaign intended to teach people about the dangers and costs of the deadly drug. Their campaign includes a video produced by the Kentucky State Police, Operation UNITE, the High Intensity Drug Trafficking Areas Program and the Kentucky National Guard.

"They're going to try to show that video as often as they can between now and January across the state to try to get a grassroots effort behind this bill," Estep said on KET's "Comment on Kentucky" Friday night. "They didn't start off early enough last time to get that to happen." Meanwhile, the number of reported meth labs in the state climbed to nearly 1,100 in 2010 and is on track to exceed 1,400 in 2011.

Pseudoephedrine is the key ingredient in manufacturing methamphetamine, which can be made by combining a few ingredients in a pop bottle. Last year, Sen. Tom Jensen, R-London, sponsored a bill to make "pseudo" available only by prescription. Jensen told Kentucky Health News Monday he is planning on introducing a bill in the upcoming session that "deals with pseudoephedrine and how to control that." "The details of that are not ready to be sent out yet," he said. "I'm negotiating with some other members to see if we can get support."

Pseudoephedrine is also a main ingredient in cold and allergy medicine. Opponents say making it a prescription-only medicine is unnecessarily inconvenient and could be costly. In a legislative brief, the Kentucky Chamber of Commerce said the proposed law would drive up insurance premiums for Kentucky employers and the taxpayers' cost of Medicaid. Their estimates show the new law would result in 17,000 more doctor visits per year. The chamber and other opponents are backed by the Consumer Healthcare Products Association, which was the top-spending lobby against Jensen's bill.

Only Oregon and Mississippi have passed laws making pseudoephedrine available only by prescription; both have seen the number of meth labs fall sharply. Mississippi, where a ban took effect in 2010, has seen a 66 percent drop, according to the Mississippi Bureau of Narcotics. Oregon has seen a 96 percent drop in meth labs in the five years since its law passed, said Jackie Steele, commonwealth's attorney for Laurel and Knox counties and a proponent of limiting pseudoephedrine access.

Opponents say the drops in Oregon and Mississippi have led to surges in adjoining states, and Steele said "They're probably correct. But I'm looking out for Laurel and Knox and the Commonwealth of Kentucky. I hope that everybody else gets on board so we don't have to worry about shuffling problems to another county or another state."

Though several individual municipalities in Missouri have made pseudoephedrine available only by prescription, Steele said that is not likely to happen in Kentucky counties since there would be "constitutional issues."

At the meeting in Laurel County last week, Abby Hale, co-director of the Laurel County Department of Public Safety and Emergency Management, said cleanup of a meth lab can cost up to $2,100 just in manpower and disposal, reports Nita Johnson of The Sentinel-Echo in London. If meth labs are inside a home, homeowners have to get the building decontaminated at their own expense, which can cost up to $3,000.

Statewide, Steele said the cost of meth is in the millions because of the expense of corrections; local health departments dealing with skin irritations and rashes; loss of learning time for kids in school; and putting children in foster care. "The Kentucky State Police spent $2 million in meth lab cleanups, not to prosecute them, just to clean the toxic dumps up," Steele said. "So you can see that the cost per year is staggering."

Funding available to help communities fight cervical cancer

For the second year, agencies, coalitions and community groups are invited to apply for funding to improve cervical cancer screening rates and human papillomavirus (HPV) vaccinations in their areas. Cervical Cancer-Free Kentucky, housed in the University of Kentucky College of Public Health, has funding available and will be awarding mini-grants in the coming year, Ann Blackford of the UK news service reports.

In August, 13 agencies received CCFKy funding ranging from $7,000 to 20,000 for projects that will help residents in 19 Kentucky counties.

"CCFKy saw great results from the first year of funded projects," said Dr. Baretta R. Casey, director of CCFKy. "The projects' outcomes convinced our team that increasing the number of funded agencies in the second year will move our mission of a cervical cancer-free Kentucky forward. Let's stop the deaths of women in Kentucky from this preventable and curable disease."

About 391 women are diagnosed with cervical cancer every year in Kentucky and 66 Kentucky women die. (Read more)

Pregnant Beyonce And Tina Knowles

Tina Knowles and Beyonce Knowles at The Launch Of House Of Dereon By Beyonce And Tina Knowles at Selfridges on September 17, 2011 in London, England.