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 officials said the state allowed another managed-care provider not to include ARH in its network, which meant a lot of higher-risk, higher-cost patients ended up covered by Coventry," the
Lexington Herald-Leader reports. "Blaming the state, Coventry had notified ARH that it was going to terminate its contract Friday. About 25,000 Medicaid recipients in the ARH service area would have been affected."
ARH then sued Coventry in U.S. District Court and asked for an injunction to continue coverage, which Coventry had said it would end yesterday. The state ordered it to maintain coverage for 30 days, and Senior Judge Karl Forester ordered ARH and Coventry to negotiate.
After yesterday's hearing, the adversaries and the state "all said the goal was for patients to continue receiving care through Appalachian Regional Healthcare's hospitals in Eastern Kentucky on a long-term basis," the Herald-Leader reports. "If the health care chain and Coventry reach an impasse, cabinet officials said procedures could be expedited with Coventry's cooperation. That would allow Coventry members to switch to another insurance provider and continue receiving services at ARH, considered the largest health care chain in Eastern Kentucky." (Read more)
ARH has hospitals in Harlan, Hazard, Hindman, McDowell, Middlesboro, West Liberty and Whitesburg, as well as three in West Virginia, including Williamson, on the Kentucky border.
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 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....
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....
The state has ordered Medicaid managed-care firm Coventry Cares to keep paying for its members to be treated at Appalachian Regional Healthcare hospitals for at least 30 days, rather than stopping tomorrow -- when a federal judge will hold a hearing in...
Appalachian Regional Healthcare, a hospital chain in Eastern Kentucky and southern West Virginia, is seeking an emergency injunction by a federal judge ordering Coventry Cares to let its Kentucky members continue receiving services from the hospitals,...