Tag Archives: medicaid

Business/Economics, Technology, U.S.

Government Incompetence: Utah health worker releases private info, hackers steal even more info. 800,000 people affected

The U.S. state of Utah experienced a leak of personal information on the internet after a state Medicaid worker accidentally published the info of 280,000 people  on the internet.

The Federal Bureau of Investigation is also looking into a possible hack job as well, that affected another 500,000 people.

In total almost 800,000 people, who’ve applied for help with medical care, are affected.

Utah state officials claim they will notify those whose info was made public.  They also warn that people should expect scammers to try to use their personal info to get to their money.

 

Business/Economics, Idaho, U.S.

Government & Corporate Incompetence: Idaho punishes California’s Molina for screwing up Medicaid payments, some health care providers went out of business

Idaho is still trying to get back $10 million in overpayments, that Molina screwed up when they took over Idaho’s Medicaid payment system in 2010.

Idaho officials say they turned over the payment system to California based Molina Medicaid Solutions, to comply with Federal regulations.

The move cost taxpayers big time, and it shut down a few health care providers.

What happened was that at the beginning of Molina’s take over providers weren’t getting paid, for as long as two months!  Many providers came close to bankruptcy, and a few went out of business.

The state made emergency payments, then Molina went and finally responded by paying the original claims.  The result was double payments!

The state of Idaho is punishing Molina by reducing the amount of money they were originally to be paid.  Also, Idaho is trying to recoup the money from the double payments.

Molina has made improvements to their customer service, but as of this year they still have 10,000 claims pending, with just under 5% being more than a month old.  One northern Idaho mental health provider says her payment claims still get delayed for no reason.

 

Idaho, U.S.

Idaho cuts Medicaid again, limits choice of providers, gets sued

Idaho’s slash and burning of Medicaid continues.  The latest cuts are taking away $34 million in state funding.

Idaho began their destruction of Medicaid services last year.  By October of 2010 a total of $105 million in state and federal cuts hit Idaho’s Medicaid program.

Some Idaho dentists say they are providing free services, out of sympathy for patients who’re being denied needed services, because of Idaho’s cuts.  Idaho lawmakers claim the cuts to the Medicaid dental program do not affect “necessary” dental services, but, dentists point out that many of the treatments being hit by funding cuts actually prevent more serious conditions, and would be more cost effective.

On top of that Idaho is now limiting providers, in some cases only one provider is allowed.  This has resulted in a lawsuit, brought by two disabled men and their families.  It could turn into a class action suit.

The new Idaho rules actually violate federal laws which protect a patient’s right to choose which provider they want.

 

Business/Economics, Idaho, U.S.

What Economic Recovery? Idaho Stops Medicaid payments

June 20, Idaho Department of Health and Welfare says they’re out of money for Medicaid.

As a result, Medicaid payments to Idaho hospitals will be suspended for at least one week.  Those payments would have come to $13 million.  Officials will announce, by the end of the week, if payments will be delayed for another week.

This isn’t the first time Idaho stopped Medicaid payments to hospitals.  In 2010 they suspended nine weeks of payments.  Health and Welfare officials say that for some reason the majority of payment claims always come in when state Medicaid funds are at their lowest point.

 

Idaho

In time for Elections, Idaho cuts Medicaid by another $8 Million, more to come

15% of Idahoans, who rely on Medicaid, are going to be hit with yet more cuts, to the tune of $8 million, with more cuts on the way.

Already this year there have been about $22 million in state funding cuts, and $83 million in federal funding cuts.  The cuts to dental care are causing great confusion has hundreds of dentists were cut from the program, then told they were re-instated, but that no payments would be made for ‘over treatment’.  Many dentists say the state has not clarified what qualifies as ‘over treatment’.  Also, their contracts can be canceled without reason.

According to the Associated Press, the new $8 million in cuts are targeted at mentally ill adults, and children with disabilities.  And those wont be the last of the cuts; Idaho wants to cut a total of $57 million from the 2011 Medicaid budget.

Remember Idaho has already cut hundreds of mentally ill adults off medicaid, with the result of incidents of violent crime (like the recent random shooting in Pocatello).  Here’s what one concerned Idahoan had to say: “These kinds of changes aren’t going to save us any money in the long run,” said Kelly Keele, a board member for Human Supports of Idaho. “These people are going to get worse without those services and then we’re going to bear the brunt of that in our justice system and corrections.”

By the way, the Associated Press had to file a public records request in order to reveal that the state of Idaho was planing more cuts.  That means our elected officials are trying to keep their budget cuts a secret.  Makes you feel warm all over going into the end of year holiday season.

Business/Economics, Idaho, U.S.

Idaho’s New Privatized Medicaid. Patient Care Falls, Company Profits Up.

“…Americans will not stand for privatization of the nation’s most successful programs.” This is what a critic of President Bush Jr. said back in 2007, regarding the privatization of Medicare, Medicaid and Social Security. I think the critic is uninformed because many states have already privatized some or most of their Medicaid programs. And there is plenty of evidence that shows it is not successful, at least for the recipients.

Idaho is one of the states leading the country in radical reforms to it’s Medicaid program. On June 7th, 2010, they contracted out the medical payment program of Medicaid to a California company called Molina. Payments were expected to restart July 1st. The Idaho Medical Association says some providers have been paid for only 1% of what they billed (yes, one percent). A small number of providers have been overpaid, to the sum of $1 million. Most health care providers get a message stating “pending hold”. At the same time, Molina is reporting a net income of $10.6 million for the 2nd quarter of this year. $5 million of that coming from their Medicaid unit, know as Molina Medicaid Solutions.

Idaho had another contractor running Medicaid payments, for 30 years. Then the state decided to get a new contractor, one that could provide more flexible technology. Is that new lingo for cutting services?

Molina initially blamed the payment issue on it’s computer program, but, then in August, said it was because they were understaffed. The state is also being blamed by some critics for intentionally holding back claims until the Molina takeover.

Some providers say they’re getting the “pending hold” message because Molina’s program is designed to take care of people with secondary insurance first. Patients with no secondary insurance seem to be stuck in limbo under Molina’s system.

The Idaho government shares some of the blame, of course. On top of hiring the new contractor, the state wants to cut Medicaid funding by $22 million. I can’t help think that the cuts have something to do with this Medicaid payment fiasco.

Now, Idaho has contracted out the dental care program of Medicaid. The contractor, DentaQuest, has been given the green light to cut 150-200 providers from the program (in Idaho that’s a lot). The changes go into affect on November 1st. Several East Idaho dentists said it could force people with serious dental problems into hospital emergency rooms. Also, according to Dr. Justin Bell of Idaho Falls, DentaQuest is reducing compensation to .30 cents for every dollar of care. Dr. Bell thinks this will force dentists to stop taking Medicaid.

Here’s a couple of questions: If Americans don’t want privatized Medicare, Medicaid or Social Security, where is the protest?

Also, what’s the use of the Federal Health Care Reforms if states are making up their own reforms?