The state has committed to hiring more than 50 temporary workers, both in-house and through outside contractors, to fix problems associated with the new Medicaid billing computer – work that will be ongoing though at least half of 2008.
Gov. John Baldacci last week signed the second financial order in a little over a month dealing with the failed system.
The first financial order allowed a staggering $24 million to be transferred from the Medicaid services account largely to pay for work the state thought the federal government would reimburse. Some of that work goes back to July of 2005.
It didn’t, saying in a letter from Medicaid regional offices in Boston they were “completely surprised” by news the state would still be working on the problem through 2007 and possibly into 2008. For now, those reimbursement funds are on hold.
The governor’s financial order also included money for new or extended outside contracts and inside hiring.
In the latest financial order signed July 27, for just under $710,000, 11 positions have been approved for the Office of Information Technology, nine of which will be used on the Medicaid computer. Since IT works for other state departments and essentially bills them for that work, the money to pay for the nine temporary posts was included in the $24 million financial order.
According to a letter written by the new Department of Health and Human Services Commissioner Brenda Harvey, the first financial order also covers:
• seven limited period in-house positions to support Medicaid provider relations and claims processing.
• 10 provider relations specialists and 16 medical claims evaluators through the contractor PCG.
• a business team of 10 members to focus on completing the system and making it HIPPA compliant, through the contractor Xwave.
The state’s share of the limited period in-house positions is $232,000 and $2.2 million for the PCG and Xwave contracts, according to Harvey’s letter. The hope is the federal government will pick up the other 50 percent of the personnel costs.
Richard McGreal, associate regional administrator for the Centers for Medicare and Medicaid Services, said last week Maine appears to be the only state in the country whose Medicaid system is not compliant with the privacy provisions of the Health Insurance Portability and Accountability Act. HIPPA compliance was one of the reasons given as to why the state rushed to switch over to the new system in January of last year.
When it was turned on it simply didn’t work, rejecting claims and failing to pay hundreds of thousands of bills. While the system is now paying most bills, it is not functional in other areas, McGreal said.
“The system is paying claims. The state has made great progress,” McGreal said, but “many functionalities that relate to the claim itself are not there,” like paying crossover claims for people eligible for Medicaid and Medicare, identifying third party liability and the HIPPA compliance.
“The much bigger picture is the $2 billion (Medicaid) program and our ability to understand that payments are being made in compliance with our regulations,” he said.
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