After the awarding of Kentucky’s Medicaid managed-care contracts last week, the insider chatter among industry executives and reporters is whether former Passport Health Plan executives assisted one of the big winners.

And I know what you’re thinking … how is this more than insider baseball or gossip?

Give me a couple of paragraphs to make my point about transparency, or the lack of it, Kentucky is about to experience when it comes to the $4 billion per year in Medicaid reimbursements flowing annually through the state to 800,000 recipients.

Multiple insiders tell Insider Louisville that officials at WellCare Health Plans, which received managed-care contracts in seven of eight Medicaid regions, were assisted by Consulting Strategies Team LLC, based in Frankfort, Ky.

CST partners include former Passport Executive Vice President Shannon Turner and Associate Vice President Nici Gaines, according to Kentucky Secretary of State corporate registration records.

Because of Turner’s and Gaines’ forced exits from Passport earlier this year, everyone is interested.

But few would be surprised if CST were hired by any of the three private companies – WellCare, Coventry Health Care or Centene Corp. – with winning bids.

“If you’re looking for help (with a managed-care) bid, there’s no one who knows Kentucky’s Medicaid system better than Shannon Turner,” said one source, noting that Turner formerly was Kentucky’s Medicaid commissioner in the mid-2000s under Gov. Ernie Fletcher.

That said, no one in state government or at WellCare wants to talk even about the possibility on the record in a real interview. which is the way corporations and governments do business with the media these days.

In an e-mail response to an Insider Louisville query, a WellCare spokeswoman denied any connection to CST.

“I have looked into the question you posed to me. In making its bid to participate in the commonwealth’s Medicaid managed care program, WellCare did not use, directly or indirectly, the three individuals or the entity you identified,” wrote Amy Knapp in WellCare’s media relations department.

Knapp initially asked for follow-up questions in writing, then did not respond to a voice mail again requesting an actual interview.

The CST phone number listed on the firm’s website is disconnected.

CST partners did not respond to e-mail requests for an interview, nor did they acknowledge interview requests sent via social media messaging.

Neither Health and Family Services officials nor officials at the the Finance and Administration Cabinet would agree to an actual interview.

Cindy Lanham,  director of communications at Finance and Administration, which oversaw the bids for Health and Family Services, sent this reply to our query as to whether finance officials know if CST is involved: There is no requirement for any potential vendor to disclose who may have assisted in drafting a response to a request for proposal, stated. The responses are judged on their merits.

CST was organized as a limited liability corporation in 2006, but dissolved in 2009 after its principals didn’t file a annual report, according to records with Kentucky’s Secretary of State. At that time, Turner and Gaines were Passport executives.

CST incorporation was reinstated in November 2009, according to Secretary of State documents.

On the CST website, Turner, Gaines and Melodie Shrader are listed as consultants

Here’s the CST mission statement:

CST is an experienced consulting firm specializing in the areas of health and human services. Our team of highly regarded professionals has extensive background in strategy and policy development, program design, revenue maximization, government relations, for-profit and nonprofit management. CST helps corporate and government organizations navigate today’s complex regulatory requirements to achieve their objectives in a dynamic new world.

That’s all we could find out.

And here’s what everyone is missing: The state’s cost-saving switch to private companies handling Medicaid managed care contracts is going to mean far less transparency

Because Passport’s board is drawn in part from officials at the University of Louisville, Passport’s meetings and books are open to the public under Kentucky law. The meetings and books at the new private, for-profits who will administer Medicaid in Kentucky?


This opinion post isn’t meant to be an investigation or exposé.

What was lost in State Auditor Crit Luallen’s allegations of excessive spending and questionable transfers by Passport officials is that Passport Health Plan was an efficient, effective Medicaid administrator, say Insiders, good for both Medicaid patients and for the taxpayers.

That’s not always the case, with some managed-care companies finding savings by denying legitimate care.

If  Turner et al have a consulting role at WellCare, that’s news.

WellCare is building a sizable presence in Louisville, leasing office space and hiring personnel for well-paid jobs. That’s news.

Why will no one talk about this?

As far as we can see, the dissembling and obfuscation has started early. In the press conference announcing the managed-care contracts, one of its executives refereed to WellCare as “WellCare of Illinois.”

Only when pushed by a Lexington Herald-Leader reporter did the WellCare executive acknowledge WellCare of Illinois is part of Tampa-based WellCare Health Plans, which has paid hundreds of millions in fines for securities and Medicaid fraud violations during the last five years.

Our take?

Get used to it.