Daily News | Keystone First, biggest Philly Medicaid plan, faulted by feds for denying certain services
that companies paid to manage Medicaid benefits were throwing up hurdles to care.
In early 2020, the Pennsylvania Health Law Project, a nonprofit that helps people obtain or keep Medicaid insurance, issued an alert aboutwhen they wanted to challenge service denials by Keystone First and AmeriHealth Caritas, both part of Independent Health Group. The audit covered the 2,482 denials of pediatric skilled nursing services. The auditors selected 50 of them for closer examination and found that in 10 cases the entire request was denied because Keystone didn’t have documentation proving that the child’s primary caregiver had work or school during the day.
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