All
the king's horses...
Commentary by Michael Vaughan
In case no one has noticed, the pride of Maine's ruling
party, MaineCare, is "falling from together"
and it has been for almost a year. It seems, in a
nutshell, that in their rush to implement a new (and
exciting) computer system last January, they allowed
the project to go ahead without significant testing
and without keeping any trace of the old system, which
more or less was doing the job.
Of course the company that created the mess, CNSI,
has already cashed the check, which so far amounts
to about $17 Million, about 2/3s of which is from
federal matching funds.
Another consequence of this catastrophic failure will
further put MaineCare at risk. Since this has been
dragging on for this long, any claims that are one
year old or older may not qualify for federal matching
funds. The fund match being 2 federal dollars for
every one of your tax dollars.
Since MaineCare covers 272,533 low-income Mainers,
or about 25% of the population, this massive system
failure will have far-reaching and disastrous consequences
to many in this state. According to the DHHS, about
90 percent of MaineCare's patients are children, the
elderly, and the disabled.
The Maine Medical Association has stated that most
private practices have stopped accepting new MaineCare
patients due to the DHHS computer debacle. Claim payments
have slowed to a crawl. It seems that some providers
are being incorrectly paid for services not rendered,
or overpaid, and that others are not being paid at
all.
According to Maine Hospital Association, "The
administrative expense of re-filing and accounting
for hundreds of thousands of missing claims will be
many millions of dollars." This is in addition
to the $340 million, which the state already owed
the hospitals as the result of a settlement (about
66 cents on the dollar).
The DHHS reported last month having 347,181 unpaid
claims to providers amounting to millions of dollars
currently "in suspension." As they say on
TV…."Talk to your doctor" I'm sure
you'll get an earful.
The bottom line is; it is amazing that any doctors
are continuing to treat MaineCare patients at all,
and the probable reason is, they are doing it out
of the goodness of their hearts.
So what does it mean to you the taxpayer? This is
just another example of government run foolishness
costing you millions, perhaps billions of dollars
and giving you nothing in return.
Michael Vaughan, (R-Durham) representing District
105 - Durham, part of Lisbon and New Gloucester
