Lawmakers hear complaints about Aetna

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(AP Photo/Jessica Hill, File) (AP Photo/Jessica Hill, File)

One of Kansas' three Medicaid providers came under fire again Monday for persistent problems with things like paying patients' bills.  Hospitals and nursing homes told lawmakers the problems with Aetna are getting worse, not better.

“A lot of our member hospitals have expressed concerns over the claims payment as well as credentialing, contracting,” said Tish Hollingsworth with the Kansas Hospital Association.

Patient advocacy groups, nursing homes and hospitals all repeated the same complaints about Aetna to lawmakers, just weeks after the state formally warned the company it wasn’t holding up its end of the contract with Kansas to provide Medicaid insurance.

While the state says it’s working with Aetna on an improvement plan, those who rely on the company to pay for services say they’re seeing more and more unpaid bills.

“In the bulk of (Medicaid) business, we get paid less than our costs to provide. So the longer that we have to hold on to claims, the longer that it takes to get that payment back, it increases our costs for providing that care,” Hollingsworth explained.

“If the state is going to allow companies to do business in Kansas, they need to be paid appropriately for doing those services,” said Cindy Luxem, Kansas Healthcare Association.

Aetna declined to comment on the recurring payment problems in Monday’s complaints, though elsewhere news broke that the company had replaced several members of its leadership.  Scott Brunner with Aetna told lawmakers in response to other issues raised the company has learned a lot about how to get patients the care they need in Kansas since January.

“One of the things we’ve learned and continue to learn is the need to communicate and train and retrain, communicate and re-communicate and we probably could have done more of that,” Brunner said.

Lawmakers will learn more Tuesday about the state's plan with Aetna to fix these problems.