Problems persist with Maine Medicaid computerized billing system

Aug 28 2006

Up to 10% of Medicaid payments made to providers through Maine's computerized bill-paying system are not processed correctly because of glitches in the system, state Medicaid officials have said, the Bangor Daily News reports.

Brenda Harvey, commissioner of the state Department of Health and Human Services, said at one point more than 600,000 claims were awaiting resolution because of problems with the system, which was installed in January 2005.

About 180,000 claims have not been resolved because of previous glitches, the Daily News reports.

Kirsten Figueroa, deputy commissioner of finance at DHHS, said the state has spent almost $29 million on the system so far and expects to spend a total of at least $56.3 million to complete improvements.

Harvey said the state plans to make changes to the system in six or seven phases, the first of which took place in July.

The remaining changes have been postponed until CMS officials, who will visit the state this week and again next month, give final approval to the plan, Harvey said.

Gordon Smith, executive vice president of the Maine Medical Association, said the system "still doesn't work very well." Providers have been asked to submit paper claims until the problems are resolved, which has been time consuming and has added to the confusion, according to Smith.

In addition, the state is in the process of recovering more than $500 million in interim payments it made since February 2005 to more than 4,400 providers to help them stay in business while claim payments were delayed because of the computer problems.

Figueroa said the state has recovered more than $240 million of the interim payments and expects to receive the rest by June 2007 (Bangor Daily News, 8/23).