Vinton hospital sues Medicaid insurers for underpayment
DES MOINES, Iowa (AP) — An eastern Iowa hospital is suing the insurance companies that oversee the Iowa Medicaid program claiming they have cost the small rural hospital thousands of dollars in patient revenue by refusing to fully pay for services provided to Medicaid-covered patients.
Virginia Gay Hospital located in Vinton also alleges the appeals process set up by Amerigroup, UnitedHealthcare and AmeriHealth Caritas was “virtually a sham.”
The lawsuit, initially filed in September in state court, was moved on Thursday to federal court because the lawsuit alleges violations of federal law.
Iowa privatized its state-run Medicaid program in April 2016. A year later the hospital says the insurers given management control of patient care violated their contracts and federal laws by keeping a portion of patient reimbursements claiming there had been overpayments.
Attorneys for AmeriHealth deny wrongdoing. The company withdrew from Iowa Medicaid in November 2017.
Amerigroup and UnitedHealthcare have not yet responded.
Medicaid cares for 680,000 poor and disabled Iowans.