NYS fines MVP $200,000 over some claims' issues

Aug 23, 2017

The state has fined MVP Health Plan and MVP Health Insurance $200,000 for incorrectly applying cost-sharing to members’ claims and improperly denying some claims for preventive healthcare services.

The NYS Department of Financial Services says that MVP, which has a large presence in the Rochester area, has agreed to pay the fine and correct processing procedures. The companies have also agreed to make restitution including interest.

The restitution totals about $9,000 for 356 of MVP’s customers. The violations happened between 2011 and 2013.

MVP issued a statement saying that the cost-share at issue related to less than one percent of preventive service claims and the company says  it has addressed the operational issues.