Health News
For taking "practically no steps to a comply" to a request to help thousands of patients transfer their Medicaid services, the Cabinet for Health and Family Services was held in contempt of court Monday.
U.S. Senior Judge Karl Forester said the Cabinet's refused to "process requests by patients to transfer away from Coventry Cares, a managed-care organization, in light of Coventry's impending termination of its provider contract with Appalachian Regional Healthcare," reports Valarie Honeycutt Spears for the Lexington Herald-Leader.
ARH and Coventry, part of Coventry Health and Life Insurance Co., battled it out in court earlier this year when Coventry wanted to terminate its contract in May ? six months before its contract was set to expire ? with the hospital chain, which covers 25,000 patients. In turn, ARH filed a lawsuit asking for a preliminary injunction to avoid the termination, which was ultimately granted. The injunction states Coventry must continue to pay ARH for services until Nov. 1. But the cabinet was supposed to help facilitate the transfer of patients from Coventry to Wellcare, the only other company that has a contract with ARH, in the meantime. Forester said in his order about 6,000 transfer requests "were being held by the Cabinet," Spears reports.
Mike Wynn of The Courier-Journal reports that 8,400 patients have sought to switch to Wellcare from Coventry since May.
Though Forester said he will decide whether to impose sanctions on the cabinet at a later date, but did not require "the cabinet to process transfer requests with the start of open enrollment only five weeks away," Wynn reports. The open enrollment window is between Aug. 20 and Oct. 19, Spears reports.
Cabinet attorney argued processing transfers was unnecessary since Coventry had been forced to pay for services through the open enrollment period. ARH argued stopping the requests creates confusion.
In response to the ruling, the cabinet praised Forester for acknowledging "the need to allow the Medicaid program to proceed with open enrollment so as not to cause a gap in service or confusion for members."
"Member support is extremely important and the cabinet remains committed to listening to concerns from Medicaid members about their managed-care company as well as medical providers," the statement continued.
- Coventry Must Extend Contract With Appalachian Regional Healthcare Until Nov. 1, Judge Rules
Conventry Cares must continue its contract with Appalachian Regional Healthcare through Nov. 1 so the 25,000 Eastern Kentucky Medicaid patients affected don't get "thrown under the bus," a federal judge ruled yesterday. "The health and well-being...
- Coventry Offers To Keep Paying Arh, But Less, For Treating Medicaid Patients; Asks Danville Chain To Renegotiate
Coventry Cares has offered to pay for treatments at Appalachian Regional Healthcare as a "non-contracted provider," which would mean ARH would be paid far less than it is now, but coverage for ARH's 25,000 Medicaid patient members would not be interrupted....
- Coventry, Arh At Impasse Over Medicaid; State Says Service Will Not Be Interrupted For 25,000 Affected
Though negotiations between Appalachian Regional Healthcare and Coventry Cares appear to be futile, the state is taking steps to make sure there won't be an interruption in care for the Medicaid recipients who will be affected by the impasse....
- Coventry Agrees To Keep Covering Arh Patients Until June 30
After a two-hour hearing in federal court, managed-care firm CoventryCares agreed yesterday to keep paying Appalachian Regional Healthcare for treating Medicaid patients at its hospitals through at least June 30 while negotiations continue. "Coventry...
- Appalachian Hospital Chain, Facing Loss Of 25,000 Medicaid Patients, Sues Managed-care Firms And State
"Appalachian Regional Healthcare, the largest health care system in Eastern Kentucky, has filed lawsuits against two of the state's Medicaid managed care companies, alleging that the managed care companies had not paid claims promptly," report Valarie...
Health News
Cabinet for Health and Family Services held in contempt over Medicaid services for Eastern Kentuckians
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| Hazard Appalachian Regional Medical Center, one of eight ARH hospitals. Courier-Journal photo, copyright 2000 |
U.S. Senior Judge Karl Forester said the Cabinet's refused to "process requests by patients to transfer away from Coventry Cares, a managed-care organization, in light of Coventry's impending termination of its provider contract with Appalachian Regional Healthcare," reports Valarie Honeycutt Spears for the Lexington Herald-Leader.
ARH and Coventry, part of Coventry Health and Life Insurance Co., battled it out in court earlier this year when Coventry wanted to terminate its contract in May ? six months before its contract was set to expire ? with the hospital chain, which covers 25,000 patients. In turn, ARH filed a lawsuit asking for a preliminary injunction to avoid the termination, which was ultimately granted. The injunction states Coventry must continue to pay ARH for services until Nov. 1. But the cabinet was supposed to help facilitate the transfer of patients from Coventry to Wellcare, the only other company that has a contract with ARH, in the meantime. Forester said in his order about 6,000 transfer requests "were being held by the Cabinet," Spears reports.
Mike Wynn of The Courier-Journal reports that 8,400 patients have sought to switch to Wellcare from Coventry since May.
Though Forester said he will decide whether to impose sanctions on the cabinet at a later date, but did not require "the cabinet to process transfer requests with the start of open enrollment only five weeks away," Wynn reports. The open enrollment window is between Aug. 20 and Oct. 19, Spears reports.
Cabinet attorney argued processing transfers was unnecessary since Coventry had been forced to pay for services through the open enrollment period. ARH argued stopping the requests creates confusion.
In response to the ruling, the cabinet praised Forester for acknowledging "the need to allow the Medicaid program to proceed with open enrollment so as not to cause a gap in service or confusion for members."
"Member support is extremely important and the cabinet remains committed to listening to concerns from Medicaid members about their managed-care company as well as medical providers," the statement continued.
- Coventry Must Extend Contract With Appalachian Regional Healthcare Until Nov. 1, Judge Rules
Conventry Cares must continue its contract with Appalachian Regional Healthcare through Nov. 1 so the 25,000 Eastern Kentucky Medicaid patients affected don't get "thrown under the bus," a federal judge ruled yesterday. "The health and well-being...
- Coventry Offers To Keep Paying Arh, But Less, For Treating Medicaid Patients; Asks Danville Chain To Renegotiate
Coventry Cares has offered to pay for treatments at Appalachian Regional Healthcare as a "non-contracted provider," which would mean ARH would be paid far less than it is now, but coverage for ARH's 25,000 Medicaid patient members would not be interrupted....
- Coventry, Arh At Impasse Over Medicaid; State Says Service Will Not Be Interrupted For 25,000 Affected
Though negotiations between Appalachian Regional Healthcare and Coventry Cares appear to be futile, the state is taking steps to make sure there won't be an interruption in care for the Medicaid recipients who will be affected by the impasse....
- Coventry Agrees To Keep Covering Arh Patients Until June 30
After a two-hour hearing in federal court, managed-care firm CoventryCares agreed yesterday to keep paying Appalachian Regional Healthcare for treating Medicaid patients at its hospitals through at least June 30 while negotiations continue. "Coventry...
- Appalachian Hospital Chain, Facing Loss Of 25,000 Medicaid Patients, Sues Managed-care Firms And State
"Appalachian Regional Healthcare, the largest health care system in Eastern Kentucky, has filed lawsuits against two of the state's Medicaid managed care companies, alleging that the managed care companies had not paid claims promptly," report Valarie...