WellCare Health Plans Inc. of Connecticut appears to be too busy to fix a software bug that is harming low-income adult and children Medicaid patients, the Hartford Courant is reporting today. During the summer, WellCare and two other insurance companies, Anthem and HealthNet, were discovered "accidentally" sending pharmacists computer messages saying that a prescription was not covered when in fact what should have been sent was that the prescription required prior authorization from the insurer. By law, managed care organizations are required to cover all drugs that are approved by the federal Food and Drug Administration.
Anthem and HealthNet have already fixed the problem, but Wellcare says it can't do so until December 1st. Must be part of a larger WellCare software maintenance build, I guess. It may also be because the FBI, Department of Health and Human Services, and Florida Medicaid Fraud Control Unit raided the company's Tampa, Fla., headquarters last Wednesday.
Wellcare says "to the best of its knowledge" it knows of no one who has been denied coverage, but Connecticut Attorney General Richard Blumenthal said his office has credible and plausible reports that prescriptions have been denied.