LEXINGTON, Ky. (LEX 18) — Treatment providers across Kentucky are trying to adapt following cuts from managed care organizations. These are big insurance companies the state contracts with to manage Medicaid.
Providers were notified at the end of May and cuts went into effect June 25.
Isaiah House, Kentucky's largest non-profit addiction recovery organization, tells LEX18 it is projecting a significant reduction in revenue.
"It's very detrimental to the recovery community as a whole," Kara Bell, Isaiah House chief development officer said.
Ball is primarily concerned about peer support.
"They're going to cut it down to 54 hours a year," she said.
Now, not only do peer support hours require prior authorization, they are limited. Before these cuts, there was no approval necessary.
"Once you use your total 54 hours, you're done when it comes to peer recovery," Ball said. "That's going to hurt a lot of people because that is how a lot of people stay sober."
At Ethan Health, Residential Director Roger Fox helps people recover from addiction every day. He is putting peer support in perspective as far as the recovery process.
Peer support hours vary depending on the MCO. Most MCOs have cut them down between 50 to 52 a year.
"It's not the right thing to do...it's so valuable to have someone with that shared experience and that lived experience to be there to guide you through the process," Fox said.
At Ethan Health, Fox said that the cuts are forcing them to shorten the length of stay for a client in their outpatient program. They're hoping to open a rural health clinic to expand medical services.
MCO cuts are also impacting psycho education. Making plans moving forward, for Ball, this is the reality.
"We're scared to death that we're going to lose a lot of people because insurance is really forcing the hand of making folks go to short term treatment versus long term treatment," Ball said.
Isaiah House tells LEX18 it is adjusting, trying hard to find corporate donors, getting creative in talks with individual donors as well as churches. They're also hosting a Hope and Healing 5K July 19 in Lexington at Coldstream Park.
"Every dollar that is raised is going to go to a fund that is called the Hope and Healing Fund and that is going to supplement those who are cut off during their treatment from their insurance or it is going to supplement and pay for those who can't afford treatment, don't qualify for Medicaid, don't qualify for a voucher, those kinds of things," Ball said.
Isaiah House ssaid that it's also been forced to lay a lot of people off as a result of the cuts.
