State slams Medicaid contractor for poor job, providers paying the price

Idaho's Medicaid program is docking Molina Medicaid Solutions, its outside contractor, $3 million for mishandling its contract, while at the same time trying to collect $10 million in overpayments made to providers.

Although officials with the Idaho Department of Health and Welfare say that the work being performed by Molina has gotten better in the past several months, according to the Associated Press it is making an initial payment of $12 million to the California-based company, down from an initial $15 million.

Molina won the contract, worth about $106 million, last year. However, thousands of payments to Medicaid contractors in Idaho were delayed for months at a time. Some smaller businesses dependent on Medicaid revenue were even forced to shut down.

As a result, state officials advanced $117 million in interim payments, but the claims were paid a second time after finally being processed.

"When you put in a system this big, there are going to be challenges," Molina executive account manager Del Bell said, according to the AP.

Overpayments in the Medicaid program are not uncommon. Maine overpaid providers by about $66 million over this year when it transitioned to a new payment processing system. In January, Louisiana was told it owed nearly $240 million for overpayments made to state run charity hospitals.

For more:
- read the Associated Press article
- check out the Bangor Daily News story from March

Suggested Articles

A group of investors, including drug giant Novartis, are trying to stop Proteus Digital Health's sale out of bankruptcy court.

Officials announced the CEO of Conifer will step down at the end of August.

Norfolk, Va.-based Sentara, a non-profit integrated health system, would have majority governance over the combined organization.