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posted on August 06, 2010 17:23
The director of the Idaho Department of Health and Welfare met with Molina Healthcare executives today to address continuing problems with the new claims processing system for the state’s Medicaid program. Molina Healthcare provides the claims payment system that pays out approximately $24 million a week to Idaho Medicaid providers for the medical services they provide for people with disabilities, low-income children and pregnant women.
 
The Molina system began processing claims approximately eight weeks ago, with many providers reporting they were not being fully paid for their services. Prompted by DHW concerns, Molina brought in a team to evaluate the system and operations last week, with their initial findings discussed during today’s meeting.
 
The providers most affected by the lack of payments are small Medicaid providers who rely solely on Medicaid payments for their livelihood.
 
“We have providers who have absolutely been pushed to the wall and cannot survive without payments – providers who we count on to serve some of the state’s most vulnerable citizens,” Director Richard Armstrong said. “We expect the system to work. Molina will fix the problems and we will make sure that happens as soon as possible. In the mean time we will make emergency payments to providers early next week.”
 
Armstrong directed an extra payment be made to providers who have not been regularly paid to help until the system fixes are implemented. This payment, which totals $55 million, brings the total amount the new system has paid during the first eight weeks of operation to $216 million.
 
“We are committed to serving our client, the state of Idaho Medicaid program,” said Terry Bayer chief operating officer for Molina Healthcare.  “As such, we are bringing all necessary resources to resolve issues with the local providers and ensure success.”
 
 
During Friday’s presentation, Molina officials acknowledged they were understaffed for the startup and have committed an additional 40 people to the project. These will include project managers, claims adjusters and telephone customer support staff.   
 
At the conclusion of the meeting, Director Armstrong also told Molina that accountability and communications must be improved so there is total transparency on the progress of the system fixes and the issues that remain. Molina officials expressed their support for a more “robust information flow” to everyone affected.