Amerigroup is an American
health insurance and
managed health care
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("ma ...
provider. Amerigroup covers 7.7 million seniors, people with disabilities, low-income families and other state and federally sponsored beneficiaries, and federal employees in 26 states, making it the nation’s largest provider of health care for public programs.
History
Amerigroup began as AMERICAID Community Care in 1994 and was initially aimed at the health care problems of children, mothers and pregnant women enrolled in
Medicaid
Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and per ...
. Amerigroup became a publicly traded corporation in the fall of 2001.
In 2006, Amerigroup entered the Medicare Advantage program, serving low-income people who are eligible for both
Medicare and Medicaid through special needs plans.
In 2007, Amerigroup began the operation of traditional Medicare Advantage plans. Currently, Amerigroup offers health care services through three government programs that target different segments of the country’s low-income population: Medicaid, the Children’s Health Insurance Program (CHIP) and Medicare.
On July 9, 2012,
Anthem Inc. (then known as WellPoint) entered into an agreement to acquire Amerigroup Corporation for $4.9 billion. Anthem has since re-branded to
Elevance Health, Inc.
On 1 March 2020, Amerigroup told Grays Harbor Community Hospital (GHCH) and Harbor Medical Group (HMG) of their decision to terminate their relationship with the company effective 28 June 2020.
Health care products
As of Dec. 31, 2012:
Children's Health Insurance Program
The Children's Health Insurance Program (CHIP) – formerly known as the State Children's Health Insurance Program (SCHIP) – is a program administered by the United States Department of Health and Human Services that provides matching funds to ...
(CHIP)
*A managed health care product for uninsured children not eligible for Medicaid. This product is designed for the SCHIP initiative.
Seniors and People with Disabilities (S/PD)
*A managed health care product designed for Supplemental Security Income (SSI) recipients. This population consists of low-income SPD.
Temporary Assistance for Needy Families
Temporary Assistance for Needy Families (TANF ) is a federal assistance program of the United States. It began on July 1, 1997, and succeeded the Aid to Families with Dependent Children (AFDC) program, providing cash assistance to indigent A ...
(TANF)
*A Medicaid managed health care product. This product is designed for the TANF population that consists primarily of low-income children and their mothers
FamilyCare
*A managed health care product focused on uninsured adults and parents of CHIP or Medicaid-eligible children.
Medicare Advantage
*Medicare health plans. Some are regular Medicare Advantage plans, while others focus on low-income Medicare beneficiaries -- Special Needs Plans for dual eligible beneficiaries with both Medicare and Medicaid.
National Advisory Board
In 2007, Amerigroup developed the National Advisory Board (NAB) to focus on meeting the needs of seniors and people with disabilities, who are a significant proportion of its clients. The NAB provides policy recommendations for improving programs and services for seniors and people with disabilities. Convened by
Lex Frieden
Lex Frieden (born March 5, 1949) is an American educator, researcher, disability policy expert and disability rights activist. Frieden has been called "a chief architect of the Americans with Disabilities Act." He is also regarded as a founder and ...
, who was instrumental in conceiving and drafting the Americans with Disabilities Act of 1990, the NAB is made up of 19 community advocates, health care experts and academics. The NAB advocated that the modernized health care infrastructure be required to meet the needs of people with disabilities and seniors.
Corporate social responsibility
Amerigroup Foundation
The main goals of the Amerigroup Foundation are to foster access to care, encourage safe and healthy children and families, and promote community improvement and healthy neighborhoods. In the past year, (2013) the Foundation contributed more than $3 million to various community organizations across the United States. Since inception, the Foundation has awarded $17.3 million to community health centers, service organizations, and local programs.
Volunteerism
Amerigroup has a Community Volunteers program, created to recognize and support the contributions employees make in communities across the country and to inspire others to volunteer. All Amerigroup employees receive a paid day off each year to do volunteer work in their communities.
Medicaid fraud
Former Executive Cleveland Tyson provided federal prosecutors with evidence that Amerigroup was systematically declining services to low-income pregnant women in Illinois from 2001 to 2003. Their contract with the state required that they enroll all eligible clients, but prosecutors submitted emails showing that Amerigroup had a policy of targeting healthy enrollees and specifically excluded pregnant women and others with expensive conditions.
In October 2006, a federal jury found Amerigroup liable for $48 million in damages, which was tripled by statute to $144 million. In March 2007, an additional fine of over $190 million was levied for 18,000
false claims. After appealing the judgments, Amerigroup agreed in July 2008 to settle the charges for $225 million. As a whistleblower,
qui tam
In common law, a writ of ''qui tam'' is a writ through which private individuals who assist a prosecution can receive for themselves all or part of the damages or financial penalties recovered by the government as a result of the prosecution. Its ...
provisions entitled Tyson to $56 million of the settlement.
References
External links
*{{Official website, http://www.amerigroup.com/
Health care companies based in Virginia
Health care companies established in 1994
Financial services companies established in 1994
Companies formerly listed on the New York Stock Exchange
Health insurance companies of the United States
Companies based in Virginia Beach, Virginia
2012 mergers and acquisitions
Medicare and Medicaid (United States)
1994 establishments in Virginia