CeltiCare will now accept claim adjustment requests up to 90 days after the date on EOP for the previously processed claim.
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Will continue to serve legal immigrants in Commonwealth Care Bridge Program
ST. LOUIS, May 14 — CeltiCare Health Plan of Massachusetts, a Centene Corporation (NYSE: CNC) subsidiary, today announced that the state of Massachusetts has renewed its contract to serve Commonwealth Care Bridge Program members, effective July 1, 2010. Under the contract, CeltiCare will continue to provide high-quality health insurance to Massachusetts residents enrolled in the Commonwealth Care Bridge Program, which serves the state’s legal immigrant population.
“We are pleased to continue working with the state and are committed to providing members of the Bridge program with access to excellent care and exceptional member service,” said Richard Lynch, President and CEO, CeltiCare. “Our members have expressed a high level of satisfaction with regard to the quality and value of care they have received and we look forward to working with the state of Massachusetts to bring our cost-effective, high-quality model to many more people.”
About CeltiCare Health Plan of Massachusetts
Founded in 2009, Boston-based CeltiCare Health Plan of Massachusetts is a managed care organization that provides high-quality, cost-effective health insurance to Massachusetts residents enrolled in the Commonwealth Care and Commonwealth Choice programs. CeltiCare is committed to helping its members achieve better health outcomes by providing high-quality benefits, services and wellness education. Backed by parent company Celtic Group, Inc., CeltiCare offers a new form of local managed care that is tailored to the needs of Massachusetts’ progressive healthcare system.
About Centene Corporation
Centene Corporation, a Fortune 500 company, is a leading multi-line healthcare enterprise that provides programs and related services to the rising number of under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the Children’s Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and long-term care, in addition to other state-sponsored programs, and Medicare (Special Needs Plans). Centene’s CeltiCare subsidiary offers states unique “exchange-based” and other cost-effective coverage solutions for low-income populations. The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health, life and health management, managed vision, telehealth services, and pharmacy benefits management. More information regarding Centene is available at www.centene.com.
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It has come to our attention that the co-pay amount listed on page 7 of the 3 Tiered Preferred Drug List for Plan Type II & III is inaccurate. The document incorrectly listed the co-pay amount of $2 for a 30 day supply of OTC product; the $2 co-pay is for Plan Type I members ONLY. The correct OTC co-pay information for Plan Type II and Plan Type III is as follows:
If you have additional questions regarding the co-pay amount correction please contact the CeltiCare staff at 1-866-614-1949.
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“Seal of Approval” Awarded by State’s Health Connector Authority
BOSTON, MA (July 1, 2009) – CeltiCare Health Plan of Massachusetts (CeltiCare) today announced that it has received the “Seal of Approval” from the Commonwealth Health Insurance Connector Authority (Connector Authority) for entry into the State’s Commonwealth Choice (CommChoice) program. CeltiCare’s application was unanimously approved by the Connector Authority’s Board at its June meeting.
CommChoice offers affordable, commercial health insurance products to individuals, families, and small employer groups. CommChoice is one of a variety of health insurance programs offered by the Connector Authority under the 2006 Massachusetts Health Care Reform Act.
“We are pleased to receive the Connector Authority’s seal of approval for this important healthcare program,” said Richard Lynch, president and CEO of CeltiCare. “Not only does our participation in the program allow us to extend our reach to cover more individuals and small businesses throughout Massachusetts, but it also reinforces CeltiCare’s long-term commitment to bringing superior value to Massachusetts healthcare consumers.”
Subject to regulatory approval, CeltiCare hopes to begin serving CommChoice members on January 1, 2010. CeltiCare will offer the full spectrum of CommChoice benefit plans, including Gold, Silver, Bronze and Young Adults health plans to individuals and families throughout central and eastern Massachusetts.
This is CeltiCare’s second major healthcare initiative with the Connector Authority to provide quality, affordable health options to underserved residents of Massachusetts. CeltiCare was unanimously approved by the Connector Authority’s Board in March for inclusion in the Commonwealth Care program and began serving members on July 1, 2009.
About CeltiCare Health Plan of Massachusetts
Founded in 2009, Boston-based CeltiCare Health Plan of Massachusetts is a managed care organization that provides high-quality, cost-effective health insurance to Massachusetts residents enrolled in the Commonwealth Care and Commonwealth Choice programs. CeltiCare is committed to helping its members achieve better health outcomes by providing high-quality benefits, services and wellness education. Backed by parent company Celtic Group, Inc., CeltiCare offers a new form of local managed care that is tailored to the needs of Massachusetts’ progressive healthcare system.
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Lower Rates Represent Victory for Health Care Consumers, Patrick Administration Cost Containment Efforts; Options for Members to Increase with Addition of New Plan
Holding the line on government spending without reducing benefits or increasing cost-sharing for members, the state-subsidized Commonwealth Care program today unanimously agreed to keep premium rates and base enrollee contributions flat for next year, and expanded the number of plans taking part in the program from four to five.
Originally projected to rise by two percent, the premium rates paid to the health plans and approved by the Commonwealth Health Insurance Connector Authority board of directors will actually decline slightly from the current year. The new rates take effect July 1 for one year.
“Governor Patrick has made health care cost containment a priority for the Administration,” said Administration and Finance Secretary Leslie A. Kirwan, who chairs the Health Connector board of directors. “Controlling costs helps us not only maintain, but also improve on the strong progress that health care reform has made in Massachusetts by ensuring that residents can continue to receive quality care they can afford.”
The Connector covers the entire cost of the premium for about 70 percent of the 165,000 Commonwealth Care members. The remaining members receive partial subsidies based on their income, which cannot exceed $32,508 for an individual and $66,168 for a family of four. Those who choose the lowest-priced plans next year will see no increase in their monthly premiums, and most of those who choose higher-priced options will actually pay less.
Since the inception of the program in 2006, the average annual rate of increase in premiums per covered person has been held under 4.5 percent, well below most benchmarks for health insurance.
“With more than 97 percent of Massachusetts residents insured, the Commonwealth must focus on controlling health care costs now more than ever,” said Secretary of Health and Human Services Dr. JudyAnn Bigby. “The Connector’s unanimous decision today to hold premium rates and base enrollee contributions steady is part of a statewide commitment to a multi-pronged strategy for ensuring the continued success of health care reform in Massachusetts.”
The Connector today also announced that a new insurance carrier has been added to the Commonwealth Care program, expanding the pool of doctors available to residents covered by Commonwealth Care.
Commonwealth Family Health Plan (CFHP) is a partnership between Centene Corporation and Caritas Christi Health Care. Centene is a national, multi-line health care organization with more than 1.2 million members in nine states. Caritas Christi Health Care is a local not-for-profit health care system with over 2,300 physicians and six acute care hospitals.
Through this new plan, Caritas will significantly add to the pool of primary care doctors now available to Commonwealth Care members. In addition to the Caritas network, CFHP will also be contracting with other providers for hospital, physician and ancillary services.
“As a result of an innovative procurement process, the commitment of local providers, and national interest in our landmark healthcare reform programs, we have succeeded in simultaneously lowering costs and increasing access,” said Health Connector Executive Director Jon Kingsdale. “This is a home run.”
The procurement process was headed by Health Connector Chief Financial Officer Patrick Holland. He noted that most service areas of the state that currently have only one plan to choose from will now have at least two, and that options will expand in other regions, as well.
“We are pleased with the results,” said Holland. “Not only have we increased the number of health plan options for our members, but just as importantly, we have lowered the expected cost of the program. In bringing together cost control incentives, strong financial oversight and high-quality, cost-effective health plans, we collectively have proven the value of such a powerful model, evidenced in the program’s annual expense trend over the last three years.”
The four original carriers will continue in the program. They are Boston Medical Center HealthNet Plan, Fallon Community Health Plan, Neighborhood Health Plan and Network Health.
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Boston, MA (March 12, 2009) – Commonwealth Family Health Plan today announced it was awarded the contract to manage healthcare services for Commonwealth Care members in Massachusetts. The health plan is a partnership between Celtic Group Inc. (Celtic), a subsidiary of Centene Corporation, and Caritas Christi Health Care (Caritas). Effective July 1, 2009, the health plan will serve the Central, Northern, Boston and Southern regions of Massachusetts.
The Massachusetts Commonwealth Care program is a health insurance program for low-income, working adults (up to 300% of the Federal Poverty Level) who are not eligible for Medicaid or employer-sponsored insurance. There are currently approximately 165,000 Commonwealth Care members.
Commonwealth Family Health Plan is a new, innovative managed care solution that leverages local provider relationships, national managed care experience and Celtic’s expertise in the individual health insurance market. The health plan offers a greater pool of primary care physicians available to Commonwealth Care members, as well as a full spectrum of providers and managed care services to ensure comprehensive access to all benefits required under the Commonwealth Care program.
Frederick J. Manning, Executive Vice President for Centene and Chief Executive Officer for Celtic, stated, “We are committed to provide a managed care solution for the underserved communities in Massachusetts. By promoting the medical home and preventive care, our new health plan will successfully deliver better health outcomes for the citizens of Massachusetts. Consistent with our philosophy that quality healthcare is best delivered locally, our health plan will hire local staff to meet the needs of the members and communities we will serve.”
Ralph de la Torre, M.D., President and Chief Executive Officer for Caritas, stated, “This plan confirms Caritas Christi’s commitment to bring the highest quality healthcare to patients in their communities. This commitment coupled with Celtic’s national experience and financial backing, effectively position this new health plan to deliver world-class healthcare to Commonwealth Care enrollees while maintaining the fiscal responsibility owed to the citizens of the commonwealth.”
About Commonwealth Family Health Plan
Commonwealth Family Health Plan, Inc. is a managed care organization that will provide health insurance to Massachusetts residents enrolled in the Commonwealth Care Program. A partnership between Celtic Group and Caritas Christi Health Care, Commonwealth Family Health Plan offers a new form of local managed care that is tailored to meet the needs of Massachusetts’ progressive healthcare system. Effective July 1, 2009, the plan will contract with the Commonwealth Care Health Insurance Connector Authority (Authority) to serve low-income, working adults who are not eligible for Medicaid.
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