Maine struggles with Medicaid billing system

For two years, Maine has tried to make its flawed Medicaid billing system work. Now, state administrators are ready to throw up their hands and kill the system, which has already cost the state and federal government $56 million. If administrators pull the plug, there's no other system available to pay the state's roughly 7,000 Medicaid providers.

The system immediately began rejecting claims in January 2005, when it first went live. To keep care available to patients during this period, the state sent out $500 million in estimated payments to providers. Once the system began paying bills, meanwhile, many providers were paid twice. The system can now pay most bills, but can't meet HIPAA requirements or analyze claims data. Attempts to fix the remaining problems have brought down the billing system again. The state needs to re-collect $131 million in twice-made payments if it hopes to balance its budget.

To learn more about Maine's Medicaid computing issues:
- read this piece in The Lincoln County News

Suggested Articles

Digital transgender health company Plume is expanding into employee benefits. Here's why.

According to a new report, 79% of facilities scored less than a C in terms of conformance with national cybersecurity standards.

There's a perfect storm brewing in behavioral health right now. There are opportunities opening up for innovators to help improve access to care.