LEWISTON – An ongoing state computer problem has delayed millions of dollars in payments to medical service providers in Maine, including local firms that have been unable to pay their employees.
“We’re biting our nails,” said Deb Hertell, financial manager at Richardson Hollow Mental Health Services. The Main Street business delivers mental health services to about 900 clients throughout central and western Maine.
The cause of her anxiety was a promised partial payment from the Bureau of Medical Services that would allow the local agency’s 225 employees to get paid. The state is in arrears $430,000 to the agency.
A partial payment promised for Wednesday didn’t arrive; another payment was promised by Friday. As of 4:15 p.m., the funds hadn’t been transferred, but a letter from the state indicating it would send payment convinced Richardson Hollow’s bank to cover the payroll checks late Friday afternoon.
“It’s been unbelievable,” said Hertell.
Linda Hertell, Deb’s sister and director of Richardson Hollow, said the agency typically receives $100,000 to $105,000 every week from claims processed through the state’s MaineCare program (formerly Medicaid.) Additionally it gets a $200,000 check for case management each month.
“We depend on that reimbursement every week,” said Linda Hertell.
Craig Phillips, director of Lewiston-based Common Ties, is dealing with similar anxiety. His mental health agency is owed about $60,000 in reimbursements. Phillips said they have enough money to cover payroll for another four weeks, but he’s looking at contingency plans in case the delay continues.
“We’ll have to borrow money to cover our payroll and that will cost us. … The interest charged isn’t a reimbursable expense,” said Phillips.
The delay is fallout from a new computer system that came online in the bureau last month. According to Michael Norton, spokesman for the bureau, there are still bugs in the new processing system.
In its first week of operation, about $7 million in reimbursements were made to Maine providers; Norton said a more typical amount is $25 million. There are more than 7,000 service providers who file claims with the bureau.
“In the next few weeks of the process we’ll be getting the i’s dotted and the t’s crossed,” said Norton. “We realize we are subjecting our own people and the providers to a system that is more rigid and less forgiving than the previous one. The (advantage) is we’ll come out the other end with more capability.”
The problems lie with training 7,000 providers on the new system, as well as working out software bugs.
Hertell said the changeover has been maddening. She began telling employees on Wednesday – after the partial payment didn’t arrive – that they wouldn’t get paid Friday. Worse, she said, no one in Augusta was returning her phone calls and bureau staff had been rude to her in earlier conversations.
“This has been a nightmare for agencies,” she said. Hertell and Phillips said that despite the delay, no services to their clients were affected.
Hertell said she has a $30,000 workers compensation payment that’s overdue, as well as a $70,000 health insurance payment. She can’t pay those bills until the state provides full reimbursement.
Norton said the changeover would especially affect about 1,200 agencies that rely heavily on MaineCare reimbursements. He said the bureau tried to lessen the impact on those agencies by approving them for interim, partial payments. About 142 of those agencies received partial payments the first week. Norton said Richardson Hollow should have been included in that group and wasn’t.
“They should get an interim payment tomorrow (Friday),” said Norton.
The bureau handles about 6.5 million claims a year, totaling $1.5 billion in payments.
Norton said without the computer upgrade, the bureau would have been out of compliance with federal law.
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