2012 Section 103F-107 HRS Medicaid Contracts Report - Hawaii ...

Contract:
Medicaid
Regulatory Agency: State of Georgia – DCH
Contract: Medicaid
Subcategory Issue Sanction Description Sanction
Date
CAP Monetary Quality and
Access
Hospital access requirements
in Laurens County fell below
threshold. DCH assessed
Liquidated Damages of
$100,000.00. WellCare
contracted with additional
facilities through single case
agreements, which brought
us back in line with network
adequacy requirements.
CAP Monetary Administrative Dental Data not submitted to
DCH by due date. Original
liquidated damages
assessment of $110,000.00
was reduced, upon appeal, to
$10,000.00.
CAP Monetary Administrative HIPAA website incident -
PHI was exposed, via the
internet, during the
deployment of reports
through WellCare
Production Ports. WellCare
notified all members
impacted, offered one year
of credit counseling to those
affected members, and paid
liquidated damages to DCH
in the sum of $725,000.00.
Regulatory Agency: State of Illinois - HFS/DOI
Contract: Medicaid
Category Subcategory Issue Sanction Description Sanction
Date
Fine Monetary Administrative Fine/$1,000. Failure to receive
permission to file an
amendment to financial
statements.
Fine Monetary Administrative Fine/$9,600. Failure to submit
audited financial statement.
Fine Monetary Administrative Fine/$300. Failure to submit
audited financial statement.
Fine Monetary Administrative Fine/$37,200. Failure to
submit audited financial
statement.
Fine Monetary Administrative Fine/$1,800. Failure to submit
annual financial statement.
Resolution
Date
Status
Jun-09 Jun-09 Resolved
Mar-09 Apr-09 Resolved
Apr-08 May-08 Resolved
Resolution
Date
Status
Mar-09 Mar-09 Resolved
Sep-08 Sep-08 Resolved
Sep-08 Sep-08 Resolved
Sep-08 Sep-08 Resolved
Mar-08 Mar-08 Resolved