State talks to vendors about Medicaid billing

AUGUSTA – The Baldacci administration is talking to three vendors as it considers going to a private company to take over the state’s troubled Medicaid billing system.

Many service providers were left without reimbursement checks or with incorrect payments after the state switched to a new system to handle Medicaid claims in January 2005.

Health and Human Services Commissioner Brenda Harvey said she’s now considering hiring a private vendor to take over the billing system. Harvey said this week she’s meeting with three companies that do that type of billing for other states.

More than 30 states hire fiscal agents to do that type of work, Harvey said.

The switch to a private vendor could cause 100 state workers to be moved to other jobs.

The system now in place is working for most, but not all, Medicaid claims, Harvey said.

Because the state hasn’t been able to make all of the upgrades required by the federal government, Maine’s present billing system cannot be certified. That means the state isn’t eligible for money that could be used to help pay for development and implementation of the system.

“My goal is, less than a year from now, we will have a plan in place that has full federal support, and that I can divert my attention to the other issues of this department,” said Harvey, who inherited the problems when she took over as commissioner last spring.

Medicaid helps pay for services provided by thousands of nonprofits and businesses that help the mentally ill, mentally retarded, former inmates, nursing home residents and low-income children who need dental care.

After billing problems developed, some providers had to close while others received estimated payments to keep them in business.

The two-year budget proposed last week by Gov. John Baldacci allows the Department of Health and Human Services to hire an outside company to handle the billing, and to move 100 positions from the state’s billing department to other positions, Harvey said.