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Shannyn Moore: Governor should straighten out Alaska's Medicaid payment mess

Shannyn Moore

Last week the attorney general of Texas sued Xerox Corp. The same day Texas' Medicaid agency announced it was ending its $759 million contract with the firm.

It ended its contract three years early "for cause." The state claims it lost hundreds of millions of dollars because Xerox wasn't scrutinizing claims enough.

New Hampshire also hired Xerox. The Medicaid payment system was supposed to be up and running in 2007. Wow. I remember that year; it was a long time ago. The system finally went live in spring 2013.

Montana awarded a $70 million contract in 2009 to Xerox. It hasn't made its deadlines and there seems to be no hope that it will be ready to go live by fall 2015 as promised. Montana is fining the corporation every day it misses a "system milestone."

Nevada hired Xerox to handle its health care exchange. It's been a disaster. It has paid only $10 million of the $72 million contract. In Xerox's defense, the corporation said it "underestimated what would go into" creating a system.

Really? After bidding on and setting up how many of these?

Wyoming, Minnesota and Idaho didn't keep them as providers. Utah, Louisiana and North Dakota are also having issues.

That brings us to Alaska. Xerox owns the company in charge of paying providers for Medicaid-covered treatments and services.

MMIS promised to have the new system delivered in 2010. It missed the mark by three years. Last October it rolled out a system full of holes and problems. Specifically, it is not paying claims and is wasting hours of employees' time on the phone trying to find remedies.

A month after the MMIS rollout Gov. Sean Parnell had a press conference regarding Medicaid. His point wasn't to chastise Xerox for a failed and late program; it was to say, "Obamacare failed to launch, is failing to deliver on its promises and remains in disarray."

Ironic, since Obama's response to a crappy website was to fire the company responsible and hire one that could do it.

The governor was busy defending his decision to lock 40,000 Alaskans out of health care by not accepting the federal money to expand Medicaid under the Affordable Care Act.

He went on, "I believe a costly Medicaid expansion, especially on top of the broken Obamacare system, is a hot mess."

The real "hot mess" is how his administration has handled Medicaid for Alaska providers.

It is shocking that Xerox/MMIS have been allowed to continue with their contract after so many failures.

In that same Nov. 15, 2013, press conference the governor announced he would form a board to address the problem. The Medicaid Reform Advisory Board appointees weren't announced until March 7. They had a organizational meeting April 23. The have another scheduled for later this month. Notably, they are not tasked with addressing the provider-payment problems.

I spoke to a doctor who didn't want his name in this column because "I'd hate for my patients to feel bad about me not getting paid."

Since October, his office has been told to hold claims for months at a time, told to switch forms, resubmit, hold, then take an advance payment. They submit 15 to 25 claims a week. They have been paid by the state an average of fewer than 1.5 claims a week. They may have to close their doors. "I'd like to take a tour of the claims office and see the stacks of claims from across the state. Are they just having potlucks in there?"

Before the system switch in October they could expect payment within 30 to 90 days.

In February there were many doctors and providers who testified in a legislative hearing that the back payments were in excess of $200 million. They told the committee they were taking loans to stay afloat and borrowing from their children's college funds.

For years we've heard about the lack of providers who take Medicaid in Alaska. It isn't helping one bit that some of the ones who do are on the brink of shuttering their businesses. In 2006 a commission was put together and released a report titled "Securing an Adequate Amount of Physicians for Alaska's Needs." I went over the 124 pages and "not paying doctors" wasn't in it.

Health care providers are a backbone of small businesses in Alaska. They keep us healthy whether we are on Medicaid or not. There are 140,000 patients seen through Medicaid provisions, and the smaller offices aren't able to survive doing volunteer work. See, it's pro-business to fix that problem.

I realize Medicaid, Obamacare and affordable health care aren't priorities for this governor. But he may want to cool off a few of his own "hot messes" before pointing at others.

Shannyn Moore is a radio broadcaster. You can hear her show, The Last Word, Monday through Friday from 4- 6 p.m. on KOAN 95.5 FM and 1080 AM and 1480 We Act Radio in Washington, D.C., and on Netroots Radio.


Shannyn Moore
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