March 28, 2022
Payers
  • The Florida State Agency for Health Care Administration suspended Medicaid and long-term care enrollment in Sunshine State Health Plan, a Centene subsidiary, after a computer glitch led the plan to mistakenly deny medical claims for more than 121,100 lower-income adults and children. The Sunshine State Health plan must meet four criteria before the state will begin to re-enroll individuals in the plan: pay a nearly $9.1 million fine within 30 days, submit a plan for how it aims to reprocess all provider and patient claims within 21 days, demonstrate within 30 days that future claims are paid promptly, and participate in weekly phone calls with the agency’s senior executives about how the process is going. (Article here)