Health News
- Passport Health Claims State Violated Bidding Process And Will Make Medicaid Overpayments In Jefferson County As A Result
Passport Health Plan has charged that the state of Kentucky has violated its own bidding process and will spend as much as $80 million more than necessary per year under its new Medicaid managed-care contracts for the Jefferson County region. Tom Loftus...
- Four Companies Will Oversee Medicaid Coverage In 16-county Louisville Region That Includes 175,000 Kentuckians
Beginning Jan. 1, four companies will share management of the health care of roughly 175,000 Medicaid patients in the Jefferson County region. This reflects a major, federally mandated change that some say raises concerns about disrupting care. The nonprofit...
- Most Medicaid Recipients Can Switch Their Managed Care Company From Now Through Oct. 19
Medicaid recipients in 104 counties who want to change who provides their managed care will have an opportunity to do so during open enrollment now through Oct. 19. Letters are being sent out by the Kentucky Department of Medicaid Services to inform...
- Significant Management Improvements At Passport Health Plan, Audit Finds
Passport Health Plan has improved significantly since a 2010 audit uncovered wasteful spending and other problems, a new audit has concluded. The managed care organization that cares for Medicaid recipients in Jefferson and 15 surrounding counties "has...
- Passport To Lose Exclusive Contract For Louisville-area Medicaid At End Of 2012; More Choice Needed, Federal Agency Says
The exclusive contract the state has with Passport Health Plan, which provides Medicaid coverage for 170,000 people in Jefferson and 16 neighboring counties, has been extended until the end of next year. But after that, the state must adopt a different...
Health News
Company to pay $2 million for doctoring Medicaid documents
The company that administers Medicaid for Jefferson and 15 other counties will pay more than $2 million in damages because it falsified documents to get a bonus.
AmeriHealth Mercy's altered data increased its score for the number of cervical cancer screenings its providers performed in 2009 and resulted in a bonus of $677,000. Attorney General Jack Conway said Wednesday that a whistleblower contacted his office nine months ago saying the company doctored reports that claimed the number of hysterectomies or Pap smears women had received.
AmeriHealth Mercy is the third-party administrator for Passport Health Plan, which manages Medicaid for about 165,000 members in Jefferson, Oldham, Trimble, Carroll, Henry, Shelby, Spencer, Bullitt, Nelson, Washington, Marion, Larue, Hardin, Grayson, Meade and Breckinridge counties. Passport manages the Medicaid program in those counties, while AmeriHealth processes the day-to-day claims as per a contact it holds with Passport. In a written statement, Passport said it may change its third-party administrator for some services.
AmeriHealth Mercy's altered data increased its score for the number of cervical cancer screenings its providers performed in 2009 and resulted in a bonus of $677,000. Attorney General Jack Conway said Wednesday that a whistleblower contacted his office nine months ago saying the company doctored reports that claimed the number of hysterectomies or Pap smears women had received.
AmeriHealth Mercy is the third-party administrator for Passport Health Plan, which manages Medicaid for about 165,000 members in Jefferson, Oldham, Trimble, Carroll, Henry, Shelby, Spencer, Bullitt, Nelson, Washington, Marion, Larue, Hardin, Grayson, Meade and Breckinridge counties. Passport manages the Medicaid program in those counties, while AmeriHealth processes the day-to-day claims as per a contact it holds with Passport. In a written statement, Passport said it may change its third-party administrator for some services.
In an agreement with Conway's office, AmeriHealth will pay $2,032,758, which represents triple the amount it received in bonus money. The state is entitled to triple damages in these types of fraud cases. Because they both fund the program, the money will be split between the federal and state governments, The Lexington-Herald Leader reports.
Passport has been scrutinized by State Auditor Crit Luallen, who found the company squandered funds on meals, travel, lobbying and other expenses. Luallen further determined two top officials with the company were guilty of conflicts of interest. While overseeing the contract with AmeriHealth, the officials were also paid as consultants for the company, The Courier-Journal reports. Since the audit, Passport has fired two executives and hired an interim chief executive.
To read coverage from The Courier-Journal, click here; the Lexington Herald-Leader, here.
- Passport Health Claims State Violated Bidding Process And Will Make Medicaid Overpayments In Jefferson County As A Result
Passport Health Plan has charged that the state of Kentucky has violated its own bidding process and will spend as much as $80 million more than necessary per year under its new Medicaid managed-care contracts for the Jefferson County region. Tom Loftus...
- Four Companies Will Oversee Medicaid Coverage In 16-county Louisville Region That Includes 175,000 Kentuckians
Beginning Jan. 1, four companies will share management of the health care of roughly 175,000 Medicaid patients in the Jefferson County region. This reflects a major, federally mandated change that some say raises concerns about disrupting care. The nonprofit...
- Most Medicaid Recipients Can Switch Their Managed Care Company From Now Through Oct. 19
Medicaid recipients in 104 counties who want to change who provides their managed care will have an opportunity to do so during open enrollment now through Oct. 19. Letters are being sent out by the Kentucky Department of Medicaid Services to inform...
- Significant Management Improvements At Passport Health Plan, Audit Finds
Passport Health Plan has improved significantly since a 2010 audit uncovered wasteful spending and other problems, a new audit has concluded. The managed care organization that cares for Medicaid recipients in Jefferson and 15 surrounding counties "has...
- Passport To Lose Exclusive Contract For Louisville-area Medicaid At End Of 2012; More Choice Needed, Federal Agency Says
The exclusive contract the state has with Passport Health Plan, which provides Medicaid coverage for 170,000 people in Jefferson and 16 neighboring counties, has been extended until the end of next year. But after that, the state must adopt a different...