Lawrence (Kan.) Memorial Hospital officials are claiming the three insurance companies managing KanCare, the state's privatized Medicaid system, routinely deny legitimate claims to hold down costs, according to a Lawrence Journal-World report.
All three contractors have denied the claim.
Here are four things to know about the charges.
1. Hospital officials made the charges during a recent meeting of the Kansas Legislature's joint committee that oversees KanCare.
2. Taryn Schraad, who handles audits and insurance claims appeals at LMH, told a legislative panel the hospital receives denial notices on a frequent basis, but there is often no explanation, according to the report. "I believe there is a pattern of behavior to just deny claims and see if the provider will spend the time and the energy and the money to pursue them through the appeal process," Ms. Schraad told reporters after the legislative meeting, according to the Lawrence Journal-World.
3. But officials from all three of the companies that manage KanCare, including United Healthcare, Sunflower Health Plan and Amerigroup, contend they provide some kind of explanation when they send out denial notices, according to the report.
4. According to the Lawrence-Journal World, Kansas Legislature's joint committee encouraged LMH to come back with examples of claim denials it thinks were unreasonable or unexplained.
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