Although the managed care organizations (MCOs) in the CCC Plus program paid over $120 million in April to catch-up on the backlog of unpaid claims for nursing center care, many underlying claims processing issues at some MCOs appear to persist. To seek relief for members from this situation, on May 1 VHCA-VCAL President and CEO Keith Hare sent a letter to the Director of the Department of Medical Assistance Services (DMAS) Dr. Jennifer Lee that outlines why there is a significant need for our members to have a level of certainty regarding claims processing.

His letter explains that VHCA-VCAL is “seeking assurances that there are meaningful remedies available to nursing centers in the event the MCOs fail to correct the now months-long claims processing issues, as well as designated consequences for the MCOs.”  Click here to read the letter in its entirety.

We will continue to keep you apprised of developments.