A contact dispute with D.C. Chartered Health Plan, the largest Medicaid contractor in Washington, DC, over "actuarially sound rates" for dental care has resulted in the city agreeing to pay a $10.2 million settlement, the Washington Post reported.
Chartered Health Plan had requested $14.9 million from the Contract Appeals Board in September.
Acting on a previous court settlement where it pledged to increase access to dental care, district officials had the contractor significantly increase its Medicaid payouts to lure more dentists to low-income areas, the article stated. D.C. Chartered Health Plan claimed that their ability to control costs was subsequently compromised.
While managed care providers accept the risk of not having the sum of their costs covered by set rates, an impending contract negotiation between the city and its two managed care providers -- D.C. Chartered Health Plan and UnitedHealth -- compelled the district to settle, the Post noted.
A lump sum of $3.7 million will be paid in addition to $6.5 million that will stem from a higher premium paid to D.C. Chartered Health Plan than UnitedHealth, the article stated.
