LEWISTON – Dr. John Bennett was overpaid for X-raying Medicaid patients when a state computer hiccuped.

His bookkeeper tried to give the money back. She was told to hold onto it because the computer wasn’t programmed to take it back.

Bennett couldn’t return the money. He couldn’t spend it. He was stuck with it.

It sits in his business’ bank account along with his group’s other earnings. Except it wasn’t earned.

Bennett said he doesn’t feel right about pocketing $102,000 of taxpayers’ money – even for the time being.

If the state were to continue to refuse to take it back before the end of the year, Bennett said he would have to pay corporate taxes on it. Something he shouldn’t have to do – considering it’s not his money.

Pounds of errors

It wasn’t a one-time error. The $102,000 represents thousands of patients’ claims, he said in an interview at his office at Central Maine Medical Center. The computer at the Department of Health and Human Services has repeatedly paid single claims more than once. It also has overpaid the amount the state owed for a given procedure.

In addition, state officials sent Bennett’s office a random $15,000 bulk payment after their computer had been denying his patients’ claims. Because that money wasn’t assigned to a specific claim, he said it can’t be applied to any accounts that are owed money.

Besides the overpayments, the state has declined to pay hundreds of claims due to computer errors, and has underpaid hundreds of others, Bennett said.

These accounting glitches have been a nuisance, he said. But they have been a greater burden to Bennett’s bookkeeper, an independent contractor who hadn’t bargained on the extra effort and paperwork.

April Martin said she had to file stacks of forms with DHS seeking billing adjustments. Documents mailed to clerks weighed in at 26 pounds for one stack and 19 pounds for another, she said.

Since February, she has put in an average of 15 extra hours a week tracking the errors and posting the necessary adjustments with DHS in an effort to set the record straight.

“It’s been very time-consuming. It’s taken a lot out of me personally,” she said. “There’s been many times when you just want to give up.”

Yet, even with all her efforts, all is not in order.

State officials told her they had a backlog of adjustment forms dating back 1½ years that need to be sorted before they are fed into their computer.

Back on track

In January, the state replaced its old mainframe computer with a new one. The $22 million system was supposed to handle Medicaid payments faster and more efficiently than the old one.

That hasn’t happened.

It performed so poorly that many doctors and other health care workers who treat Medicaid patients in Maine were not paid at all earlier this year. Then, to make up for the mistake, they were paid lump sums. In the process, many were overpaid by a total of roughly $51 million.

Then the state asked those overpaid the largest amounts to give the money back.

But Medicaid providers like Bennett were told not to return surplus money because the computer wasn’t programmed to take it back. In some cases, the state’s Web site and clerks have conveyed conflicting information to Medicaid providers.

“The frustration we have is that the state put a (computer) system in place without really testing it,” Bennett said. “Over very prolonged period of time, they have not been able to rectify it.”

At a news conference scheduled for today, Gov. John Baldacci is expected to announce plans to get Medicaid billing back on track.

Bugs in the new computer system, purchased from the Maryland company CNSI, are still being worked out, said DHS spokesman Michael Norton. The state has withheld $5 million of the purchase price until the computer is error-free, he said. The company has stationed technicians in Augusta since its installation.

“The level of product management and diligence was not what we would have like to see,” he said. Still, he added, “There’s been quite a bit of progress.”

Technicians hope to have the computer working by October, he said.

Bennett said he’s glad he’s a doctor and not an accountant.

“I couldn’t stand it. I would just walk out the door, I’d be so aggravated.”


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