Sunshine Health Medicaid Lawsuit

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Florida fines Medicaid insurer Sunshine Health for claim denials

(7 days ago) People also askDid Sunshine Health Plan pay a $9 million fine early?Sunshine Health Plan paid the fine early. Florida’s largest Medicaid managed care plan paid a $9 million fine this week for failing to pay, or to timely pay, 121,227 claims from health care providers.Sunshine Health Plan settles $9M+ fine for violating Medicaid contractfloridapolitics.comWhat happened to Sunshine Medicaid?Medicaid Assistant Deputy Secretary Brian Meyer on March 17 sent a letter to Sunshine President and CEO Nathan Landsbaum advising him of the $9,092,025 penalty and other corrective actions the state was taking against the health plan after failing to pay the providers. The state levied a $75 fine for each delinquent payment.Sunshine Health Plan settles $9M+ fine for violating Medicaid contractfloridapolitics.comHow long does Sunshine have to pay a Medicaid fine?The state is giving Sunshine 30 days to pay the fine. Florida’s largest Medicaid managed care vendor, which came under scrutiny for failing to pay claims for sick children over several months, is being fined a record $9 million by the Agency for Health Care Administration ( AHCA ).Florida Medicaid hits Sunshine Health with $9M sanction floridapolitics.comWhy did Sunshine State fail to pay health care claims?Sunshine State Health Plan Inc. said payment glitches related to the company’s merger with WellCare of Florida Inc. caused it to fail to pay health care claims for months for some of Florida's sickest and neediest children. (Times 2007)Florida failed for nearly 3 months to pay tens of thousands of health tampabay.comFeedbackFlorida Politicshttps://floridapolitics.com/archives/517178Sunshine Health Plan settles $9M+ fine for violating Medicaid …WebSunshine Health Plan paid the fine early. Florida’s largest Medicaid managed care plan paid a $9 million fine this week for failing to pay, or to timely pay, 121,227 claims from health care

https://www.ocala.com/story/news/healthcare/2022/04/03/florida-fines-medicaid-insurer-sunshine-health-claim-denials/7216226001/#:~:text=Florida%E2%80%99s%20Agency%20for%20Health%20Care%20Administration%2C%20which%20is,Plan%20for%20improperly%20denying%20more%20than%20120%2C000%20claims.

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Florida’s largest Medicaid payment vendor must pay nearly $9.1

(1 days ago) WebSunshine State Health Plan Inc. of Tampa had until 5 p.m. Thursday to dispute the large fine imposed last month by its government regulator, the Agency for …

https://www.wuft.org/fresh-take-florida/2022-04-08/floridas-largest-medicaid-payment-vendor-must-pay-nearly-9-1-million-after-missing-deadline-to-challenge-government-fine

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Complaints, Grievances and Appeals Florida Medicaid - Sunshine …

(6 days ago) WebWrite us or call us within 60 days of our decision about the services. You can contact us at: Children’s Medical Services Health Plan. Grievance and Appeals. P.O. Box 459087. Fort …

https://www.sunshinehealth.com/members/cms/resources/complaints-appeals.html

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Florida fines Tampa Medicaid payment vendor nearly $9.1 million …

(2 days ago) WebGAINESVILLE – Florida fined its largest Medicaid payment vendor nearly $9.1 million over software problems that delayed payments for nearly three months for …

https://www.tampabay.com/news/health/2022/03/23/florida-fines-tampa-medicaid-payment-vendor-nearly-91-million-over-billing-glitches/

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Florida fines Medicaid insurer Sunshine Health for claim denials

(7 days ago) Web0:21. Florida’s Agency for Health Care Administration, which is responsible for administering the state’s Medicaid program, has issued a fine of over $9 million to …

https://www.ocala.com/story/news/healthcare/2022/04/03/florida-fines-medicaid-insurer-sunshine-health-claim-denials/7216226001/

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Judge gives the go-ahead to Medicaid class-action lawsuit against

(9 days ago) WebA federal judge has cleared the way for a class-action lawsuit that alleges Florida did not properly inform people before dropping them from the Medicaid program …

https://health.wusf.usf.edu/health-news-florida/2024-04-30/judge-gives-medicaid-class-action-lawsuit-against-florida-the-go-ahead

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Florida Medicaid hits Sunshine Health with $9M sanction for not …

(8 days ago) WebFinally, the state is requiring the health plan to offer training to providers on proper claims submission processes. There are more than 5 million people enrolled in …

https://www.mostlymedicaid.com/florida-medicaid-hits-sunshine-health-with-9m-sanction-for-not-paying-providers-claims/

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U.S. District judge clears Medicaid class action suit to proceed

(3 days ago) WebA federal judge has cleared the way for a class-action lawsuit that alleges Florida did not properly inform people before dropping them from the Medicaid program …

https://news.wgcu.org/health/2024-04-29/u-s-district-judge-clears-medicaid-class-action-suit-to-proceed

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Medicaid enrollment in Florida continues to drop - Health News …

(6 days ago) WebThe issue also affects managed-care organizations that contract with the state to oversee care for most Medicaid beneficiaries. Centene Corp., which is a major …

https://health.wusf.usf.edu/health-news-florida/2023-11-16/medicaid-enrollment-in-florida-continues-to-drop-amid-redetermination-process

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Florida appeals a federal judge's ruling in a Medicaid dispute

(Just Now) WebLawyers for the Florida Agency for Health Care Administration last week filed a notice at the 11th U.S. Circuit Court of Appeals that is a first step in challenging a …

https://health.wusf.usf.edu/health-news-florida/2024-03-29/florida-appeals-a-federal-judges-ruling-in-a-medicaid-dispute

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Florida failed for nearly 3 months to pay tens of thousands of …

(8 days ago) WebPublished Feb. 14, 2022. GAINESVILLE – Florida failed for nearly three months to pay tens of thousands of health care claims for the state’s sickest and neediest children due to …

https://www.tampabay.com/news/health/2022/02/14/florida-failed-for-nearly-3-months-to-pay-tens-of-thousands-of-health-claims-for-children/

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Class-Action Lawsuit OK’d Against Florida’s ‘Unwinding’ Of Medicaid

(7 days ago) WebA federal judge has cleared the way for a class-action lawsuit that alleges Florida did not properly inform people before dropping them from the Medicaid program …

https://kffhealthnews.org/morning-breakout/class-action-lawsuit-okd-against-floridas-unwinding-of-medicaid/

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Provider Complaints Sunshine Health

(2 days ago) WebFor claims related issues, Sunshine Health allows providers ninety (90) days from the date of the final determination of the primary payer to file a complaint. To file a complaint, …

https://www.sunshinehealth.com/providers/resources/file-a-complaint.html

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IN THE UNITED STATES DISTRICT COURT FOR THE …

(7 days ago) Webfor the time he was dedicating to her care. Ms. Aughnay claims she gave him the $260,500.00 under duress and that she woul d not have made thes e additional loans …

https://cases.justia.com/federal/district-courts/georgia/gandce/1:2019cv02607/265018/13/0.pdf?ts=1577960080

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Carr: Medicaid Fraud Division Obtains Recoveries in Excess of $85

(5 days ago) WebATLANTA, GA – Attorney General Chris Carr today announced that the office’s Medicaid Fraud Division has obtained civil recoveries totaling more than $68 …

https://law.georgia.gov/press-releases/2022-04-05/carr-medicaid-fraud-division-obtains-recoveries-excess-85-million

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Cityblock, Sunshine Health Partner to Deliver Care to Florida …

(5 days ago) WebWhat You Should Know: – Cityblock, a value-based healthcare provider specializing in Medicaid, announced a new partnership with Sunshine Health, a Florida …

https://hitconsultant.net/2024/05/21/cityblock-sunshine-health-partnership/

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Southern District of New York U.S. Attorney Announces $10.1 …

(8 days ago) WebDamian Williams, the United States Attorney for the Southern District of New York, and Naomi Gruchacz, the Special Agent in Charge of the New York Regional …

https://www.justice.gov/usao-sdny/pr/us-attorney-announces-101-million-settlement-managed-long-term-care-plan-improper

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Parents of disabled children sue Indiana over Medicaid changes

(9 days ago) WebThe mothers named in the suit care for a 6-year-old boy with rare genetic disorder called cri-du-chat syndrome and a 10-year-old who has hypoxic-ischemic encephalopathy, a type …

https://www.msn.com/en-us/news/us/parents-of-disabled-children-sue-indiana-over-medicaid-changes-addressing-1-billion-shortfall/ar-BB1mAqNG

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UnitedHealth argues against case alleging wrongful AI care denials …

(8 days ago) WebUnitedHealth argues algorithm lawsuit should be dismissed because patients didn’t spend years appealing denials. By Bob Herman and Casey Ross May 22, …

https://www.statnews.com/2024/05/22/unitedhealth-class-action-lawsuit-algorithm-motion-to-dismiss/

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Judge's ruling after revised lawsuit slows fight over Medicaid

(6 days ago) WebThe lawsuit is rooted in last spring’s end of a federal public health emergency that was declared in 2020 because of the COVID-19 pandemic. Medicaid is …

https://health.wusf.usf.edu/health-news-florida/2024-01-25/judges-ruling-after-revised-lawsuit-slows-fight-over-medicaid-redetermination

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Steward sued by Brighton Marine over health care contract

(6 days ago) WebThe news: Brighton Marine Inc. filed a lawsuit earlier this month alleging that Steward was interfering with its efforts to drop the bankrupt hospital company as its main …

https://www.bostonglobe.com/2024/05/30/business/steward-bankruptcy-lawsuits/

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Florida Medicaid & Health Insurance Sunshine Health

(1 days ago) WebDiscover job opportunities with Sunshine Health Works. We urge all providers to utilize the prior authorization form alongside the dedicated fax line for DME/HHC …

https://www.sunshinehealth.com/

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3 power conferences join ACC in asking Florida court to keep the …

(Just Now) WebThe filing was a response to Florida Attorney General Ashley Moody’s complaint last month in which she accused the ACC of breaking Florida’s public records …

https://www.washingtontimes.com/news/2024/may/30/3-power-conferences-join-acc-in-asking-florida-cou/

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Discrimination and negligence at Seattle Children’s hospital led to

(9 days ago) WebThe family of Sahana Ramesh filed a lawsuit in Washington’s King County Superior Court against Seattle Children’s hospital, Children’s University Medical Group …

https://www.cnn.com/2024/05/24/us/sahana-ramesh-lawsuit-seattle-reaj/index.html

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Judge decides to not issue final judgment now in Central Health case

(2 days ago) Web0:04. 0:45. A Travis County state district judge has decided not to issue a final judgment in the 2017 lawsuit against Central Health for funding projects that a …

https://www.statesman.com/story/news/healthcare/2024/05/23/central-health-lawsuit-travis-county-judge-does-not-issue-final-judgment-in-case/73821414007/

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For Markus Johnson, Prison and Mental Illness Equaled a Death …

(7 days ago) WebIt was 1:19 p.m. on Sept. 6, 2019, in the Danville Correctional Center, a medium-security prison a few hours south of Chicago. Mr. Johnson, 21 and serving a …

https://www.nytimes.com/2024/05/05/us/politics/prison-mental-health-care.html

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Alpharetta road closing Tuesday for fatal crash investigation

(7 days ago) WebThe single-vehicle crash occurred on May 14 when the driver of the car lost control, and the car flipped upside down and crashed into the tree line.

https://www.11alive.com/article/traffic/alpharetta-road-close-fatal-crash-investigation/85-93e65483-5615-4417-abb2-086677de1c7c

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Rachel Somerstein's 'Invisible Birth' chronicles the history of C

(8 days ago) WebApproximately one in every three births in the U.S. occurs as the result of a C-section. When journalist and professor Rachel Somerstein had an emergency C-section …

https://www.npr.org/2024/05/28/nx-s1-4977627/rachel-somerstein-invisible-labor-c-section

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Lawsuit claims COYO was told product wasn't suitable for dairy …

(6 days ago) WebA Queensland "dairy-free" ice cream and yoghurt company was told its product wasn't suitable to be marketed as "dairy-free" years prior to the anaphylaxis death of a …

https://www.abc.net.au/news/2024-05-27/coyo-allegedly-warned-yoghurt-not-dairy-free-before-death/103886510

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Non-Discrimination Notice Sunshine Health

(8 days ago) WebIf you believe that Sunshine Health has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can …

https://www.sunshinehealth.com/members/medicaid/resources/non-discrimination-notice.html

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Ascension Hospitals Reel From Cyberattack, Causing Patient Care …

(1 days ago) WebAscension, one of the nation’s largest medical systems with 140 hospitals in 19 states, has yet to recover from a large-scale cyberattack earlier this month. Lauren …

https://www.nytimes.com/2024/05/23/health/cyberattack-ascension-hospitals-patient-data.html

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West Virginia's first ombudsman for state's heavily burdened …

(5 days ago) WebCHARLESTON, W.Va. (AP) — The first ombudsman of West Virginia’s heavily burdened foster care system has resigned. Pamela Woodman-Kaehler’s resignation will …

https://apnews.com/article/west-virginia-foster-care-ombudsman-9c87fe573d3c0f74877e61254b99d040

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A lawsuit claims a Palm Beach County health - Health News Florida

(Just Now) WebA recent lawsuit alleges Palm Beach Health Network shared "highly sensitive personal information" with Facebook’s parent company, Meta, according to the South …

https://health.wusf.usf.edu/health-news-florida/2024-05-27/a-lawsuit-claims-a-palm-beach-county-health-network-shared-patient-info-with-meta

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Lawsuit seeks to block Washington parental rights law that critics …

(9 days ago) WebThose 13 and older have the right to outpatient behavioral health treatment. and youth seeking reproductive health care and gender affirming care.” Others who …

https://apnews.com/article/parents-rights-students-lgbtq-abortion-washington-c4811c0938ecdf758cd4b6a019f9b8c5

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Reporting Healthcare Fraud, Waste & Abuse Sunshine Health

(9 days ago) WebTo report suspected fraud, waste, abuse, or neglect in the Florida Healthy Kids programs, please use one of the following avenues: AHCA Consumer Complaint Hotline: 1-888-419 …

https://www.sunshinehealth.com/members/cms/resources/reducing-fraud/reducing-fraud21.html

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6 key facts about abortion laws and the 2024 election : Shots

(7 days ago) Web2. Bans are affecting where doctors work. Idaho illustrates how abortion bans can affect a state's broader health care system. Doctors are leaving the state, and …

https://www.npr.org/sections/health-shots/2024/05/22/1252771024/state-abortion-laws-2024-election

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