Amerigroup Agreement Update
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Ref: Amerigroup Agreement Update
From: Vickie Guarraci
After numerous and lengthy discussions between Ameirgoup and CARE, we are very close to finalizing the Agreement.
What was needed:
1. The body of the Agreement required additional language changes that were left over recommendations
from Bob Fogg’s review.
2. The MLTSS Attachment, required minimal; however, important modifications. Particular to term and “Any
Willing Provider” language.
3. Attachment A, which was presented late in the negotiations and contains all of the reimbursement
schedules required significant changes. Specifically, the rates and inclusion language.
Final issues: (Order of concern)
1. Attachment A – language which allows Ameirgroup to make changes to the rate during the term of the
Agreement. Amerigroup may stand firm on this issue since we have been discussing this for over a year.
2. Remove the language, “all inclusive Room and Board plus ancillary” in the Service Description section for
custodial compensation. (The State’s definition for custodial care may be enough to protect Providers on
this issue; however, it would be better if it was not ambiguous)
3. Attachment A – retroactive reimbursement for changes in State Medicaid Specific Rate. Currently, they
want a 60 day allowance to be applied on a prospective basis.
The Amerigroup Agreement will be one Agreement, as is the current one, with all SNFs and ALs listed and joined in an Attachment. The rates that CARE has had in place for Ameirgroup’s other lines of business will be combined into this one Agreement. Amerigroup will not be reducing the rates that CARE previously negotiated. Be advised that these are not the rates that Ameirigoup has with other Providers.
We are waiting for Amerigroup to provide their response to the three remaining issues. We will inform our Providers once we receive their response. At that time, it is doubtful that there will be any more room for negotiations.
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