AETNA Better Health of Virginia (Aetna)

Case ID	Date	Points	Issue Type	Description
20467	8/4/2022	0	Care Coordination	No Valid Screening Prior to NF admission. (APPEALED - CAP Rescinded)
20348	5/20/2022	1	Other	Use of inaccurate Level of Care (LOC) benefit information resulting in capitation overpayments.
20078	9/21/2021	10	Financial	Error in FICA tax processes by MCO's Fiscal/Employer Agent (F/EA) vendor.
20077	9/21/2021	10	Other	Migration of online web portal and website platform without approval by Department of Medical Assistance Services (DMAS).
20076	9/21/2021	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).
19947	8/31/2021	5	Reporting	Aetna submitted four (4) SA Medical files to CRMS Production without approval from DMAS. This incident will again lead to inaccurate data in the production environment and delays to critical projects for DMAS while the error is addressed.
19927	7/16/2021	5	Other	System issues impacting CRMS SA data submission.
19588	2/23/2021	1	Care Coordination	Inaccurate Level of Care (LOC) assessment.