ARH and Coventry debate continues in federal court

By: Katie Roach Email
By: Katie Roach Email

The debate continues between Appalachian Regional Healthcare and Coventry officials.

Both sides went back to court in Lexington on Tuesday.

A judge heard testimony on whether the MCO provider could maintain a viable network without ARH.

ARH, Coventry, and the state all presented arguments.

Most of the hearing centered on what federal and state law says about driving distances to hospitals and physicians and how that distance should be calculated.

As of June 30th of this year, Coventry and ARH will no longer have a contract.

It was made clear that in Coventry's contract with the state, in a rural area, patients must live within 60 minutes of a hospital.

ARH submitted close to 20 exhibits into evidence of maps and driving distances using MapQuest from places in eastern Kentucky to non ARH hospitals in the area giving many examples of places where it could take more than one hour for patients to receive specific services.

But, Coventry submitted evidence about driving distances using a software called Geo Access that they say is standard in the industry. It estimates driving times from zipcodes using a 65 mile per hour speed limit for rural areas.

Using their software, Coventry officials say only very small majority would not fall within the regulations.

For those close to the limit, they would make out of network exceptions.

ARH said that those calculations were not an accurate portrayal of what driving distances are really like.

As for the Cabinent of Health Family Services, they say they have looked at Coventry's network without ARH and they say that it will be in compliance.

Ultimately a federal judge will decide whether Coventry's network will be viable.

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