Following last week’s decision to reinstate dental and vision benefits to the state’s Medicaid recipients, Gov. of Kentucky Matt Bevin’s administration has made the call to suspend Medicaid copays priced from $1 to $50 by Aug. 1.
Many Medicaid healthcare providers are being kept in the dark as the agency makes sudden changes, but this week their surprise was met with relief upon hearing the news the co-pays were tabled. Ramona Johnson, CEO of Bridgehaven told the Courier Journal: “I’m glad they made that decision … but it’s difficult not knowing the rules and having the rules change so fast.”
This action will halt Medicaid copays for services such as, prescription drugs, doctors’ visits and hospital stays. Kentucky’s acting Medicaid commissioner Jill Hunter sent an email to officials last week notifying them of the changes but specifying the suspension of copayments as temporary.
AHCCCS has received CMS approval, but hasn’t rolled out its AHCCCS Care program. Under the new program, Arizona will asks Medicaid beneficiaries above 100 percent of FPL to also contribute to their care through monthly premiums (less than 2 percent of household income or $25) to an AHCCCS Care FSA and make co-insurance payments, which is collected after the service is received.
AHCCCS Care Coinsurance
- $4 for brand name drugs when generics are available and for opioid prescriptions or refills
- $8 for non-emergency use of the emergency room.
- $5 or $10 for specialist services without a PCP referral
Failure to Pay: In Arizona, Medicaid beneficiaries above 100 FPL will have a two month grace period to make payments. Members who do not make timely premium payments will be disenrolled, but may re-enroll at any time. There is no lockout period.
In Kentucky, the Spokesman for the Cabinet for Health and Family Services Doug Hogan said the agency would be revisiting how to best implement copays. There is confusion among providers about the co-pays, because of lack of guidance from the Kentucky’s Medicaid agency. Many patient advocates are also concerned that state officials are not taking into account the impact copays have on already cash-strapped, low-income Medicaid beneficiaries.
University of Louisville medical school internist Dr. Barbara Casper told the Courier even when their facility had a $2 copay patients could not cover it but they also do not turn them away. “This was a problem before we had the Medicaid expansion,” she said.
It seems to be a guessing game with Kentucky’s Medicaid program now.
Read the Courier’s article here.
Check out this Hertel Report story for background on Kentucky’s Medicaid rulings.