Thursday, August 5, 2010

Health and Welfare: Molina will be Penalized

Posted By on Thu, Aug 5, 2010 at 9:40 AM

Molina, the third party administrator contracted to manage Idaho's Medicaid billing and reimbursement systems, will pay for mistakes that have resulted in thousands of caregivers not being paid in a timely fashion.

In BW's reporting we've told you how Molina won the bid to manage Health and Welfare's massive billing and disbursement operations. Since early July—when Molina officially took over the process—doctors, therapists, nursing homes and thousands of providers have been paid very little of amounts due, and in some cases, not at all. In addition, BW has also reported missing or insufficient reconciliation of disbursements, leading to bookkeeping nightmares across the state. And in some instances, patient billing information was mailed to the wrong providers.

On Aug. .4, a regional Health and Welfare representative said the department's contract with California-based Molina stipulates that if it does not perform as expected, Molina can be penalized, either by withholding funds or a fine.

"We are planning on penalizing them," said Ron Beecher, Health and Welfare administrator.

On Friday, Aug. 6, Molina officials are expected to be in Boise for an in-person meeting with Health and Welfare officials to discuss the situation. Additionally, Health and Welfare is planning on building a new webpage to help Medicaid providers track progress. The site is expected to be up by next week.

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