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.

“Medicaid’s rates pay 75 percent of the cost of treating patients on an in-patient basis,” reports Valarie Honeycutt Spears for the Lexington Herald-Leader. “Coventry has asked for a further reduction.”

“The ultimate issue is whether patients in that region are going to have access to care or not. ARH needs to be paid if they are going to treat these patients,” said Steve Price, an attorney for ARH.

Stephen Amato, Coventry’s attorney, said Coventry’s offer is a sign the company “remains committed to the best interest of its members in hopes that its willingness to preserve its members’ access to ARH takes its members out of the middle of the contract dispute.”

Coventry is one of four companies chosen by the state to provide care to Medicaid recipients. ARH sued Coventry, and another managed-care company, saying they owed the hospital chain more than $18 million for services. But Coventry says the state allowed another managed-care company not to include ARH in its network, which means a lot of higher-risk, higher-cost patients covered by Coventry.

Meanwhile, Coventry has given notice to the Ephraim McDowell Health System, which has facilities in six counties including hospitals in Danville and Stanford, that it wants to renegotiate its contract. (Read more)