- THE ASSOCIATED PRESS
- Last Updated: June 13, 2012 – 12:26 pm
LEXINGTON, Ky. — A federal judge has heard arguments in a dispute over Medicaid services.
The Lexington Herald-Leader and The Courier-Journal report that lawyers for Appalachian Regional Healthcare and managed-care company Coventry Cares were in court Tuesday arguing over whether Coventry could serve the needs of 25,000 eastern Kentucky Medicaid patients without using ARH facilities. The regional heathcare system has eight hospitals and other health clinics throughout the region.
Coventry has said it intends to sever its contract with ARH, but agreed to negotiate until June 30 after the healthcare system filed suit in federal court. The negotiations have been unsuccessful, so now the sides are arguing over whether residents in eastern Kentucky have access to healthcare without ARH facilities.
Coventry argued that it can meet Medicaid guidelines of maintaining hospital services within a one-hour drive of rural residents.
“We established that the network was adequate under the reasonable standards accepted in the industry,” Stephen Amato, an attorney for Coventry, said after the hearing. “By no means should anyone conclude that Coventry is not committed to giving the members … full access to health care. We’ll do that no matter what the judge decides about this issue about adequacy.”
ARH argued that 10 areas don’t have enough providers outside its network to meet the guidelines, and that thousands of people will face a longer commute.
“That’s a hole in the region that’s as big as the hole that sank the Titanic,” Price said. “You ought to let passengers off before the boat sinks.”
He asked that Coventry patients be allowed to sign up with Wellpoint, another managed care provider with which ARH has a contract.
After hearing five hours of testimony, the judge asked both sides to submit additional briefs by Thursday. He did not indicate when he would rule on the matter.
The state Cabinet for Health and Family Services hired Coventry and three other companies on Nov. 1 to manage Medicaid in Kentucky.
Christina Heavrin, an attorney for the Cabinet for Health and Family Services, said Tuesday that Coventry had an adequate network of providers without ARH facilities.