More Medicaid Systems Woes

Two years ago I wrote about how state's Medicaid claims processing systems seem to be one of the most difficult IT projects to develop. Maine, North Carolina and Indiana, just to name a few, were having difficulties building workable systems. Now it's Idaho's turn. As reported by the Idaho Statesman:

The state has fallen eight weeks behind in Medicaid payments to many of the 15,000 businesses that serve Medicaid patients because of a new payment management system that began July 1. The payments are managed by a private contractor, Molina Information Systems LLC.

. . . Some problems in the transition to a new system were expected. Then, compounding the situation, the department notified businesses in April that Medicaid payments for the last three weeks of June wouldn't be paid until after July 1, the new fiscal year, because the state was running out of money to pay its Medicaid bills and needed to tap the new year's funds by at least $27.6 million.

But neither the state nor the providers anticipated that switching to the new Medicaid management information system would go as poorly as it has. Molina has held up payments to many caregivers while overpaying a few others by more than $1 million.

I've been told that this problem will probably continue. But the ones that suffer, as the Statesman points out, as well as other reports, are the health care providers who aren't receiving payments and face going out of business.