Coventry Cares and ARH
Posted in the Pikeville Forum
#1 Apr 25, 2012
Some pregnant women in Bell County might have to change doctors and drive nearly an hour for care just weeks before their babies are due.
Officials say Coventry Cares is terminating its contract with ARH next month, which means patients have to find new doctors.
Amanda Asher is 34 weeks pregnant and experiencing complications. Now just six weeks before her due date, the Coventry Cares insurance patient has to leave her doctor at Middlesboro ARH.
"It's very stressful. You lay and wonder and it's not healthy for the baby either for you to be so stressed out," said Asher.
Coventry Cares is one of the companies paid to manage Kentucky Medicaid patients.
ARH officials say Coventry told them they were terminating the contract with ARH on May 4th. Coventry claims they were forced to until Kentucky treats all MCOs equally.
This means patients like Asher and Rebecca Smith, who is seven months pregnant with high blood pressure, will have to drive to Corbin for obstetrician services.
"It's really hard once you get used to a doctor having to switch to another one," said Smith.
"It's not fair that I have to switch my doctor in my 8th month and drive 30-40 miles out of the way," said Asher.
The women say this not only affects their health, but also their pocketbook.
"I find myself laying awake at night worrying, am I going to get the gas money to go to this doctor," said Smith, whose husband is on disability and she works part-time.
Asher says her husband was recently laid off from his job.
The women say they will have to make the the drive because the situation with ARH and Coventry Cares will not be resolved before their babies arrive.
ARH has filed a federal lawsuit against Coventry Cares alleging they have not paid claims promptly.
Coventry Cares officials have called the lawsuit "baseless" and "counterproductive."
#2 May 2, 2012
ARH and Coventry Care have been ordered into negotiations by a judge:
Negotiations will start at nine o'clock Thursday morning between ARH and Coventry Care officials.
A federal judge has ordered the two companies to sit down together and negotiate.
She also ordered that every two hours, the court be notified about the status of settlement negotiations.
If an agreement is not reached by Friday night, thousands could be without a local health care provider and hundreds of employees may lose their jobs.
A hearing on the matter is set for Friday morning in Lexington.
#3 May 3, 2012
d: Wed 11:03 PM, May 02, 2012A A
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State official says Coventry Care must continue paying for services at ARH for 30 days
A state official says an insurance provider must continue paying for members to be treated at ARH facilities for 30 days.
The Lexington Herald reports Coventry Care was notified by letter that they cannot discontinue coverage for them as of May 4th.
Officials say that would have affected thousands of patients and caused layoffs at ARH.
Meanwhile, a federal judge has ordered the two sides to meet and try to settle their differences.
That begins Thursday morning.
Some have called on the governor to resolve the dispute.
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