Thursday, May 17, 2007
from the Kennebec Journal
Sport of Kings
New Medicaid billing system inspires doubts among some
Christmas spirit
Guidance counselor: Dismiss complaint based on criticism of same-sex marriage
CHELSEA: 'Practice burn' provides thrill for 9-year-old
Trust eyes orchard purchase
GOLFER OF THE YEAR: Bonenfant rises up Cony ranks
YOUTH SOCCER: Local team gives 'care package' to children in Afghanistan
All of today's:
News | Sports
from the Kennebec Journal
from the Morning Sentinel
YES ON 1 BACKER REBUTS CLAIM
New system for Medicaid payments worries providers
After petition drive, Clinton police force budget will go a third time before voters
A rock musician makes trip home via Black Taxi
MADISON: After revaluation, abatement requests reviewed
Parks to have facelift
GOLFER OF THE YEAR: Sweet does job for Madison
YOUTH SOCCER: Local team gives 'care package' to children in Afghanistan
All of today's:
News | Sports
from the Morning Sentinel
There's "deadbeat," "hapless," "incompetent." Then there's "unconscionable," "derelict" and "irresponsible."
Whatever you choose to call it, the state's failure to pay providers of Medicaid services years after they did the work now amounts to stealing. If the state was a private individual, they'd have been taken to the collection agency and small claims court long ago. If the state was a private insurance company, it would have been shut down by now -- by the state bureau of insurance.
Yes, we know that a lousy computer system bollixed everything up. But a computer system is an inanimate object. People who run businesses -- dentists, doctors, physical therapists, hospital administrators -- aren't. And this problem is hurting people. For all the state's commitment to its small businesses and large employers, this strung-out episode is putting the lie to that commitment.
Every time a reporter dips or digs into the issue for the latest update, they find businesses that are hurting. Doctors who won't take Medicaid patients any more because it's unlikely they'll get paid to take them. Hospital administrators at their wits' end. The story's the same, but there's a seemingly infinite cast of victims. And while the state took steps to reimburse providers with so-called interim payments, those payments have hardly settled the outstanding claims.
It's hard to believe that this is a problem that totally defies solution. We can only surmise that somebody, somewhere in state government has made the calculation that we're in so deep, we can't afford to get out of a billing system that's the cyber-version of an unending nightmare. And now the state is saying that it will be three years before a new system will be up and running. Hard to swallow.
Surely, there are some diabolical geniuses out there in the world where computers and finance overlap, who can figure this one out. They're probably only 14 years old, but at this point, we'll put our faith in anyone other than the discredited functionaries in Maine state government. Those folks need to go back to school, and let somebody competent and responsible take over this mess. No more excuses.
Reader comments
Sort by: Oldest first | Newest First
1-9 of 9 comments:
The innane accusations that providers who accept Mainecare are morally deficient, committing billing fraud and unworthy of reimbursement is just another attempt to marginalize this accounting debocle. This sham is a mockery of a travesty and as a provider of services paid by Mainecare I will be approaching the State for reimbursement of my losses as I an enttled according to Public Law 2005, Chapter 519.
report abuse
Your loyal online readers will SURELY remind you of THIS missive on the "deadbeat," "hapless," "incompetent." Then there's "unconscionable," "derelict" and "irresponsible." State's ability to handle THIS medical insurance issue when they start pushing "single payer" on us and you support them.report abuse
Accountability is a 2-way street and some providers in the state would stop their incessant drum beat with their friends in the media if they knew their books and their billing codes and procedures were going to be more closely scrutinized. Perhaps it is easier for some Medicaid providers to run to a sympathetic media as it makes for "good press" than to have their payments properly accounted and audited.
It is true that the State of Maine certainly deserves the blame for the MECMS mess, however, there are sound reasons why some payments are held up and there is an appeals process for providers to to be heard should they choose to exercise that right.
Is the KJ suggesting that we throw even more money at the Medicaid providers and worry about the accounting and the regulations concerning the payments of Medicaid dollars "later"?
I must say as a taxpayer, I am astonished to hear the KJ trumpet for more "business as usual" between the Medicaid community and the State especially given the vacuuous lack of accountability with respect to Medicaid dollars.
IMO, former REP. Stan Moody is dead on when he writes, "It is time to Call in the Feds."
report abuse
There is one word missing in this otherwise excellent op-ed...accountability.
No one has been held accountable for this mess. Not the head of DHHS, not the managers responsible for the gross incompetence during the entire process, not the consultants, not the vendor....no one.
Why isn't the Governor launching an investigation? Where is the outrage in the Legislature? $50+ MILLION dollars flushed away and NO ONE is held responsible.
Incompetence at all levels. Any wonder why everything this government touches costs more than most other states?
report abuse
You are so right if this was anyone else but the state they would have been burned at the stake by now. To the people that say state workers don't play computer games; read the KJ online; send those chain e-mails that tell you to e-mail it on to 5,10, etc. people and it will come true. Please!!! Then there are the ones that are just plain incompetent-as this issue is a glaring example of that.
Every time that I've been put in a state office as a temp employee, I witnessed first hand the goofing off but of course those of us that were temping did the bulk of the work while the talking heads received the credit. I worked for a totally inept supervisor in the Consent Decree Office, I was accused of errors that I didn't commit and God forbid but I saw many things wrong with the ISP's but I was fired for that. I was told, "It isn't your job to read them, just enter into the computer." From what I saw they didn't read them either. report abuse
Wow! About time the mainstream media started calling the Maine Medicaid mess what it is - despicable, catastrophic, and inexcusable.
Good for you, Kennebec Journal/Morning Sentinel!report abuse
As a legislator, I kept a business outside my district alive for the last year of my sojourn in Augusta by hammering on the Governor's office...Within 30 days of my exit in December, 2006, the payments dried up, and the business went belly-up...
This is nothing that an ax-swinging, turn-around specialist like David Flannagan could not handle in short order...He was, however, turned down in the beginning of the first Baldacci administration because of his brief, sacreligious foray as an Independent gubernatorial candidate...
This issue is merely a symptom of a department that is mired in moribund bureaucracy...Call in the Feds!
Stan Moody...report abuse
You must be a registered user of MaineToday.com to post a comment. Register or log in.