Health News
- Danville Newspaper Examines Problems Hospitals And Doctors Have With State's Managed-care Medicaid Program
All the talk about "Obamacare" may have obscured Kentucky's biggest health-care story, Kendra Peek of The Advocate-Messenger in Danville suggests, in a look at Kentucky's troublesome shift to managed-care Medicaid. "It's the biggest story...
- State's Largest Health Care System Says It Will End Contract With Coventry Cares
KentuckyOne Health, the state's largest health-care system with almost 200 hospitals, physician groups, primary care centers and other agencies, is canceling its contracts with Coventry Cares, one of the state's four Medicaid managed-care organizations....
- 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....
- Managed-care Firm Coventry Threatens To Terminate Contracts Of Baptist Healthcare And Big Ashland Hospital
Lexington Herald-Leader photo by Charles BertramIssues with the state's managed-care companies continue to mount. Now Coventry Cares has told Baptist Healthcare System, which has hospitals in Lexington, Louisville, La Grange, Paducah and Corbin,...
Health News
Managed-care firm blames state for problems leading to impending end of contract with ARH hospitals
In the face of a lawsuit that alleges it did not pay claims promptly, Coventry Health and Life Insurance Co. blamed the state for problems that have surfaced since managed care was implemented. Coventry has canceled its contract with Appalachian Regional Healthcare, which has sued the company as well as Kentucky Spirit Health Plan Inc., reports Nola Sizemore for the Harlan Daily Enterprise.
"The current crisis would have never occurred except for the commonwealth's failure to make timely and reasonable decisions on three major issues," Coventry Executive Vice President Timothy Nolan said in a letter to ARH President Jerry W. Haynes. The issues are "a failure to implement a risk adjustment methodology, failure to find a solution to the supplemental hospital payment issue and errors in the original data book and failure to ensure all MCOs meet the same robust standards for network adequacy," Sizemore reports. MCOs are managed-care organizations.
Conventry Health and Kentucky Spirit are two of three MCOs chosen to manage the state's Medicaid program. Since they took over Nov. 1, there have been repeated complaints about delayed payments, as well as burdensome rules requiring doctors to get pre-authorization from the companies before they can provide care.
ARH treats about 25,000 Medicaid patients at its eight hospitals. In the past six months, nearly 11,000 Medicaid visits have been made at the Harlan facility alone, with 7,800 of them covered by Coventry, said Mark Bell, community and patient advocate. This will "present a complex and serious crisis for everyone," he said. (Read more)
"The current crisis would have never occurred except for the commonwealth's failure to make timely and reasonable decisions on three major issues," Coventry Executive Vice President Timothy Nolan said in a letter to ARH President Jerry W. Haynes. The issues are "a failure to implement a risk adjustment methodology, failure to find a solution to the supplemental hospital payment issue and errors in the original data book and failure to ensure all MCOs meet the same robust standards for network adequacy," Sizemore reports. MCOs are managed-care organizations.
Conventry Health and Kentucky Spirit are two of three MCOs chosen to manage the state's Medicaid program. Since they took over Nov. 1, there have been repeated complaints about delayed payments, as well as burdensome rules requiring doctors to get pre-authorization from the companies before they can provide care.
ARH treats about 25,000 Medicaid patients at its eight hospitals. In the past six months, nearly 11,000 Medicaid visits have been made at the Harlan facility alone, with 7,800 of them covered by Coventry, said Mark Bell, community and patient advocate. This will "present a complex and serious crisis for everyone," he said. (Read more)
- Danville Newspaper Examines Problems Hospitals And Doctors Have With State's Managed-care Medicaid Program
All the talk about "Obamacare" may have obscured Kentucky's biggest health-care story, Kendra Peek of The Advocate-Messenger in Danville suggests, in a look at Kentucky's troublesome shift to managed-care Medicaid. "It's the biggest story...
- State's Largest Health Care System Says It Will End Contract With Coventry Cares
KentuckyOne Health, the state's largest health-care system with almost 200 hospitals, physician groups, primary care centers and other agencies, is canceling its contracts with Coventry Cares, one of the state's four Medicaid managed-care organizations....
- 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....
- Managed-care Firm Coventry Threatens To Terminate Contracts Of Baptist Healthcare And Big Ashland Hospital
Lexington Herald-Leader photo by Charles BertramIssues with the state's managed-care companies continue to mount. Now Coventry Cares has told Baptist Healthcare System, which has hospitals in Lexington, Louisville, La Grange, Paducah and Corbin,...