Tag Archives: reform

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?