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.