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Judge Approves Settlement for Chartered Health’s Unpaid Claims

Wednesday, August 21, 2013

Judge Approves Settlement for Chartered Health’s Unpaid Claims

Settlement paves the way for providers to begin receiving payments in September

(Washington, DC) The Department of Health Care Finance (DHCF) announced today that the DC Superior Court has approved a $48 million dollar settlement with the now defunct DC Chartered Health Plan (Chartered). The settlement paves the way for providers to receive payments for claims which went unpaid when Chartered suspended payments in April.

“We are pleased by the decision handed down by DC Superior Court Judge Melvin R. Wright,” said DHCF Director, Wayne Turnage. “This sends a clear message to our providers that they are not only important to the beneficiaries they serve, but that they are considered an integral part in the system that contributes to the health and well-being of the District’s most vulnerable population.”

The Centers for Medicare and Medicaid Services (CMS) must now approve the $18 million adjustment to Chartered’s managed care rates which is included in the settlement. The process for seeking this approval was initiated today. Upon approval, the federal government will pay 70 percent of the $18 million. These funds will be provided to Chartered, who will then distribute the full amount to providers.

Following the distribution of the $18 million, DHCF will make payments totaling $30 million to providers through the Provider Stabilization and Beneficiary Access Program. Providers must submit an application to receive grant funding. All grant information is available on the DHCF website at www.dhcf.dc.gov and the agency will hold bi-weekly meetings to update providers on the status of the claims payment process.