Renee Ordway

Trying to make sense of DHHS mess

Posted March 11, 2011, at 9:23 p.m.
Last modified March 12, 2011, at 6:34 a.m.

I know our governor isn’t a fan of Maine newspapers, given his quote last week that “buying a Maine daily newspaper is like paying someone to lie to you.”

But I find newspaper archives to be an interesting place to go when trying to make sense, for example, of Thursday’s announcement that the Maine Department of Health and Human Services had overpaid Maine hospitals to the tune of about $66 million.

I swear that sounded vaguely familiar, yet I also thought I had recently heard something about MaineCare trying to find a way to pay off some of its enormous debt to Maine hospitals.

Turns out I was right on both counts. Well, at least if you believe what you read in a daily Maine newspaper.

Here was the headline in the Morning Sentinel for Friday, March 11, 2011: “DHHS: State has paid hospitals $66 million too much.”

The first paragraph said the department is $60 million over budget in MaineCare payments to hospitals because it did not properly convert to a new payment system in October.

Here is a Jan. 27, 2011, headline from this newspaper (remember that would be just six weeks ago): “County hospitals seek millions in MaineCare payments.”

Here’s the first paragraph written by reporter Jen Lynds:

“Like other facilities around the state, hospitals in Aroostook County have been waiting for years for the state to pony up the millions of dollars it owes them for care they have extended to patients covered by the MaineCare program.”

Here is what Bangor Daily News reporter Rich Hewitt wrote about the three area hospitals in Hancock County just six days earlier:

“In the supplemental budget that he proposed earlier this month, Gov. Paul LePage included about $70 million for the program, which in turn would leverage federal matching funds for a total of $248 million to pay back to Maine hospitals statewide. That would represent more than half of the $400 million the state owes in back MaineCare payments to hospitals. Collectively, the state owes the three Hancock County hospitals … about $22 million in back payments.”

So this month Maine hospitals owe the state MaineCare system $60 million, and six weeks ago the state MaineCare system owed Maine hospitals $400 million.

For a little historical perspective, I hearkened back to some newspapers published in 2005 and found this printed on May 4 of that year in the Ellsworth American:

“The DHHS may have overpaid some Medicaid providers by as much as $51 million because its new computerized billing system isn’t working.”

According to that newspaper story, the latest billing glitch was just more bad news for the agency, which already was under strong criticism for “not paying providers enough because of a computer meltdown.”

I knew it sounded familiar.

Of course, when it’s your administration in command at the time of such monumental screw-ups, it’s always tempting to blame a computer. I mean, who hasn’t blamed an unanswered e-mail or a late assignment on a computer glitch?

And, of course, this latest $66 million problem is being blamed, probably rightfully so, on Gov. John Baldacci’s administration.

Speaking of blame …

Maine Public Broadasting reporter A.J. Higgins asked House Speaker Robert Nutting for comment on Thursday’s announcement by DHHS Commissioner Mary Mayhew about the overpayment to hospitals of $66 million by MaineCare and another $30 million the state owes the federal government because of federal funds that MaineCare reimbursed inappropriately.

“Any shortfall is a big problem,” Nutting said, “And this one is really unconscionable, that someone in the previous administration knew about this and nobody told the incoming administration, so we find it out now here the second week in March. It’s just completely unacceptable.”

Nutting is, after all, the speaker of the House. It is his duty to be diligent with taxpayer money. Of course, he should be outraged at this latest MaineCare budget debacle.

Unconscionable indeed, sir!

Oh, and by the way, back to the archives.

Here are the first few paragraphs from a Portland Press Herald story from Nov. 18, 2010:

“The pharmacy once owned by House Speaker nominee Robert Nutting received more than $1 million in excess MaineCare payments that were never repaid, according to records released this week.

“True’s Pharmacy, which Nutting owned from 1970 until it closed in 2003, was found to have overbilled the state and federal program by about $1.6 million for sales of adult incontinency products.”

Nutting said the overbilling was an “honest mistake” and the money was used to “pay employees, to keep the lights on and to buy materials.”

I mean, why not, right?

When the overbilling “mistake” was discovered by the state, it wanted its money back. The pharmacy subsequently declared bankruptcy, leaving $1.3 million of that bill for the taxpayers to absorb.

A mistake to one person is an unconscionable act to another.

And what one person might call a pack of lies, another might simply call legitimately bad press.

Either way, there are lessons to be learned among those headlines.

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