Absolute Total Care-Corrective Action Plan to Address Non-compliance


This CAP is necessary in order for ATC to address their non-compliance for failure to pay claims in a timely manner.  ATC has a large number of unpaid, denied and disputed claims outstanding with providers including major hospitals, physician groups, ambulance providers and others.  ATC has contracted with SCDHHS since 2007 and serves approximately 87,700 South Carolina Medicaid enrollees in 39 counties.

This information is provided to ensure contract transparency and SCDHHS will publicly announce all CAPS.  In the event SCDHHS or its designee finds that a contractor and/or its subcontractors failed to comply with requirements of this contract, the contractor may be required to submit a CAP to SCDHHS outlining the steps it will take to correct any deficiencies and/or non-compliance issues identified by SCDHHS in the Notice of Corrective Action.

Contactors under a CAP are required to produce a plan that not only addresses the issues identified, but outlines steps necessary to sustain the corrections.  A copy of ATC’s proposed CAP can be reviewed online at www.scdhhs.gov/caps .  SCDHHS welcomes public comment regarding the CAP.  All comments should be submitted to SCDHHS by June 27, 2012.

Thank you for your continued support of the South Carolina Medicaid program.  Please refer any questions or concerns regarding this bulletin to the SCDHHS Provider Call Center at 1-888-289-0709.

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