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Centene Corporation
announced today that its Kentucky subsidiary, Kentucky Spirit Health Plan
(Kentucky Spirit), has received a decision from the Kentucky Court of
Appeals denying the Commonwealth's emergency motion for a mandatory
injunction, thereby allowing Kentucky Spirit to move forward with exiting
the Medicaid managed care program.
"Unfortunately, despite numerous opportunities to address the underlying
issues of the program, efforts to resolve these matters with the regulatory
agencies have been unsuccessful," said Deanne Lane, Vice President Corporate
Communications. "We have attempted to engage the Commonwealth in transition
planning for months without success. In the interest of our members, we have
offered to remain in the Medicaid managed care program up to August 31, 2013
and await the Commonwealth's response."
Kentucky Spirit remains focused on providing a smooth and effective
transition for the Medicaid membership and its provider network. A copy of
Centene's letter to the Commonwealth is as follows:
July 1, 2013
Richard M. Sullivan, Esq.
Conliffe, Sandmann & Sullivan, PLLC
2000 Waterfront Plaza
325 West Main Street
Louisville, Kentucky 40202
By Hand Delivery and Electronic Mail
Re: Kentucky Spirit Health Plan, Inc. v. Commonwealth of Kentucky, Finance
and Administration Cabinet, Case No. 12-CI-1373
Dear Dick:
We write to address transition issues in light of the Court of Appeals'
decision today denying the Commonwealth's emergency motion for a mandatory
injunction.
In prior correspondence, Kentucky Spirit has pointed out that if the
Commonwealth deems Kentucky Spirit to be in default of the Managed Care
Contract ("Contract") based on its July 5, 2013 exit from the Kentucky
Managed Care program, it has certain remedies available to it under the
Contract, including terminating Kentucky Spirit for default and requiring it
to remain in the program for an additional two months under Section 39.10.
Kentucky Spirit twice has offered to waive any notice periods or requirement
for default and breach (without waiving other rights, including its rights
with respect to the pending appeal of Judge Wingate's May 31, 2013 order
denying Kentucky Spirit's motion for summary judgment, including its
position that Kentucky Spirit has a right under Section 39.13 of the Managed
Care Contract to terminate the Contract early), so that before July 5, 2013,
the Commonwealth may effectuate the Contract's mechanism for requiring
Kentucky Spirit to remain in place through August 31, 2013. The
Commonwealth rejected the first offer. The renewed offer remains open
through 12:01 a.m. July 6, 2013, and Kentucky Spirit continues to be
prepared to provide services under Section 39.10 for any period of time
beyond July 5, 2013 (up to August 31, 2013) to ensure the effective
transition of members.
In the event that the Commonwealth proceeds to reassign Kentucky Spirit's
members to other vendors effective 12:01 a.m. July 6, 2013 as described in
your e-mail this afternoon -replacing Kentucky Spirit as vendor - the
reassignment will constitute a constructive termination under the Contract.
Please advise how the Commonwealth intends to proceed.
Sincerely,
Philip W. Collier
About Centene Corporation
Centene Corporation, a Fortune 500 company, is a leading multi-line
healthcare enterprise that provides programs and related services to the
rising number of under-insured and uninsured individuals. Many receive
benefits provided under Medicaid, including the State Children's Health
Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster
Care and Long-term Care (LTC), in addition to other state-sponsored/hybrid
programs, and Medicare (Special Needs Plans). The Company operates local
health plans and offers a range of health insurance solutions. It also
contracts with other healthcare and commercial organizations to provide
specialty services including behavioral health, care management software,
correctional systems healthcare, life and health management, managed vision,
pharmacy benefits management and telehealth services.
SOURCE Centene Corporation
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