Virginia MedicaidAnthem HealthKeepers Plus (Anthem)
| Case ID | Date | Points | Issue Type | Description |
| 20748 | 1/12/2023 | 10 | Reporting | Non-compliance with the Encounters Evaluation Guide and Data Quality Score Card (DQSC) for State Fiscal Year 2023, Quarter 1. |
| 20647 | 12/9/2022 | 10 | Care Coordination | Inappropriate CCC Plus Waiver enrollment. |
| 20488 | 8/3/2022 | 5 | Other | Use of inaccurate Level of Care (LOC) benefit information resulting in capitation overpayments. |
| 20190 | 2/1/2022 | 5 | Reporting | Non-compliance with the Encounters Evaluation Guide and Data Quality Score Card (DQSC) for State Fiscal Year 2023, Quarter 1. |
| 20083 | 11/17/2021 | 5 | Other | MCO granted approval for their Fiscal/Employer Agent (F/EA) to change Department of Social Services (DSS) Criminal Background Process without prior approval by Department of Medical Assistance Services (DMAS). |
| 20081 | 11/17/2021 | 10 | Other | Migration of online web portal and website platform without approval by DMAS. |
| 20080 | 11/17/2021 | 10 | Financial | Error in FICA tax processes by MCO's Fiscal/Employer Agent (F/EA) vendor. |
| 19707 | 5/4/2021 | 10 | Care Coordination | A technology-dependent member was authorized by Anthem to receive 8 hours of private duty nursing (PDN) per day, without documentation of a primary caregiver. The member was left alone without a trained primary caregiver who accepted responsibility for providing care whenever nursing was not in the home, and there was not a back-up plan when services were not rendered as planned. |
| 19488 | 6/17/2020 | 5 | Claims | Untimely claims payment. |