Despite assurance from the Department of Health and Human Services, the fact that far less than half of the state’s medical providers have signed up to participate in MaineCare is troubling. Given the long history of DHHS’s computer troubles, the low sign-up rate could indicate on-going problems, which the department should investigate now, rather than assuming things will be fine.
As part of the switch over to a new computer system, medical providers must sign up with DHHS by Dec. 23 to receive payments through the federal Medicaid program, which is administered by MaineCare.
As of early this week, only 41 percent of the state’s 4,785 providers had signed up to receive payments.
DHHS Commissioner Brenda Harvey told lawmakers last week that many doctors and dentists were procrastinating.
Stories from health care providers, however, tell a different story. One provider said his office carefully followed instructions provided by DHHS only to have its application denied because some parts of the long form were incorrectly filled out. Making the necessary corrections was also difficult.
Paula Benson, who does the books for her podiatrist husband, Dr. Daniel Benson, told the Kennebec Journal that she’s been trying to activate a new account since Oct. 6 without success. She said she’s left messages with the department, but hasn’t received return phone calls.
The fact that the department had to produce a video, staff a telephone help line and provide an in-person workshop for the new systems does not bode well for its ease of use.
This is especially problematic given the wasted money and problems associated with updating the department’s complex computer system.
The Maine Integrated Health Management Solution system, or MIHMS, is to replace the ill-fated Maine Claims Management System, or MECMS, which immediately malfunctioned when it was turned on in January 2005. This sent MaineCare providers and the state MaineCare office into financial and administrative chaos. After months of trying to fix the multiple interrelated problems within the system, officials announced MECMS would be scrapped and eventually replaced. For the past three years, the largely disabled system has been processing and paying provider claims, but not gathering and reporting essential program data as is required by the federal government. The new system, which is estimated to cost nearly $55 million — of which Maine will pay about $6 million — is designed to perform all needed functions. It is scheduled to take over MaineCare billing, reporting and other functions on Feb. 28, 2010.
It can’t function as needed if those who submit the bills and other reports aren’t part of the system.
The department should find out why providers aren’t signing up and provide the assistance they need to complete the process.