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<DIV><FONT size=2>Why would they even implement the system until testing under
reality simulating conditions showed it to be almost bug free?</FONT></DIV>
<DIV><FONT size=2></FONT> </DIV>
<DIV><FONT size=2>Idaho, where business can fuck the public over without
fear.</FONT></DIV>
<DIV><FONT size=2></FONT> </DIV>
<DIV><FONT size=2>w.</FONT></DIV>
<BLOCKQUOTE
style="BORDER-LEFT: #000000 2px solid; PADDING-LEFT: 5px; PADDING-RIGHT: 0px; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px">
<DIV style="FONT: 10pt arial">----- Original Message ----- </DIV>
<DIV
style="FONT: 10pt arial; BACKGROUND: #e4e4e4; font-color: black"><B>From:</B>
<A title=v2020@ssl1.fastmail.fm href="mailto:v2020@ssl1.fastmail.fm">Saundra
Lund</A> </DIV>
<DIV style="FONT: 10pt arial"><B>To:</B> <A title=vision2020@moscow.com
href="mailto:vision2020@moscow.com">vision2020@moscow.com</A> </DIV>
<DIV style="FONT: 10pt arial"><B>Sent:</B> Tuesday, March 29, 2011 9:02
PM</DIV>
<DIV style="FONT: 10pt arial"><B>Subject:</B> [Vision2020] Medicaid claims
malfunction could cost Idaho</DIV>
<DIV><BR></DIV>
<DIV class=WordSection1>
<P class=MsoPlainText><SPAN
style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 12pt">This
makes me absolutely spitting mad. These problems with Molina Medicaid
Solutions' (MMS) processing of Idaho's Medicaid claims has been totally FUBAR
for almost a YEAR now, yet:<o:p></o:p></SPAN></P>
<P class=MsoPlainText><o:p> </o:p></P>
<P style="MARGIN-LEFT: 0.5in"><SPAN
style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Department
of Health and Welfare officials are in talks with the Idaho attorney general's
office over how to address these issues - and how to hold Molina
accountable.<o:p></o:p></SPAN></P>
<P style="MARGIN-LEFT: 0.5in"><SPAN
style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">That
finger-pointing phase has been put on hold, for now, while Molina and state
officials concentrate on working all the bugs out of the system, said Dick
Schultz, a Health and Welfare deputy director who is managing the
project.<o:p></o:p></SPAN></P>
<P style="MARGIN-LEFT: 0.5in"><SPAN
style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">"When
the system is stable and there's no more harm being done, that's when we'll
start taking that comprehensive approach to looking at what happened," Schultz
said.<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN
style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 8.5pt"><BR></SPAN><SPAN
style="COLOR: #1f497d; FONT-SIZE: 12pt">In any case, I recommend reading the
full article for the details of the disgusting waste at a time when Medicaid
is being cut. No reasonable person can help but think that there needs
to be accountability <B>NOW</B>, and if the contract wasn’t written to protect
our taxpayer dollars in this idiotic contract with a clearly inept &
irresponsible private contractor, there needs to be a <B><U>serious
house-cleaning</U></B>. I suspect the cost to Idaho will be well over
(as in at least double) the $2 million mentioned in this
article.<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN
style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 8.5pt"><o:p> </o:p></SPAN></P>
<P class=MsoNormal><SPAN
style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><A
href="http://www.idahostatesman.com/2011/03/29/1584863/medicaid-claims-malfunction-could.html">http://www.idahostatesman.com/2011/03/29/1584863/medicaid-claims-malfunction-could.html</A><o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN
style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 8.5pt"><o:p> </o:p></SPAN></P>
<P style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in" class=MsoNormal><SPAN
style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: #999999; FONT-SIZE: 7.5pt">March
29, 2011<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 18.75pt; MARGIN-LEFT: 0.5in" class=MsoNormal><SPAN
style="FONT-FAMILY: 'Georgia','serif'; COLOR: #204060; FONT-SIZE: 18pt">Medicaid
claims malfunction could cost Idaho<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in" class=MsoNormal><B><SPAN
style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: #999999; FONT-SIZE: 7.5pt">JOHN
MILLER - Associated Press<o:p></o:p></SPAN></B></P>
<P style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in" class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 9pt"><o:p> </o:p></SPAN></P>
<P style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in" class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">Idaho's
new, problem-plagued Medicaid claims processing system may cost taxpayers
millions, according to a report released Tuesday by legislative auditors who
concluded that neither Idaho health officials, the software company nor
Medicaid providers were adequately prepared for the switch last year.
<o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">After
California-based Molina Medicaid Solutions took over the $106 million contract
in May 2010, problems handling Idaho's roughly $1.4 billion in annual Medicaid
claims emerged almost immediately. That delayed thousands of payments to
private providers who rely on the payments to provide services to the poor and
disabled. <o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">To
help keep them in business, the Department of Health and Welfare advanced
these providers a total of $117 million in interim payments in July and
August. <o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">These
companies were paid again once their original claims were processed late.
<o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">Now,
however, only about half these double payments have been recouped by the
state. And because some of those providers did eventually fold, an estimated
$2 million is now at risk of never being recovered, wrote the Legislature's
Office of Performance Evaluations. <o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">"That's
a rough estimate," said Health and Welfare spokesman Tom Shanahan. "It may be
more, it may be less. Some of them (the providers) are not billing anymore. We
believe some of them have gone out of business." <o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">There
are more issues, too, that are costing Idaho money. For instance, federal
matching rates for Medicaid are going from nearly 80 percent to 69 percent
come July 1. With so many claims delayed, that means the state is likely
losing hundreds of thousands in federal matching funds, money Idaho has to
make up in state taxpayer dollars. <o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">Department
of Health and Welfare officials are in talks with the Idaho attorney general's
office over how to address these issues - and how to hold Molina accountable.
<o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">That
finger-pointing phase has been put on hold, for now, while Molina and state
officials concentrate on working all the bugs out of the system, said Dick
Schultz, a Health and Welfare deputy director who is managing the project.
<o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">"When
the system is stable and there's no more harm being done, that's when we'll
start taking that comprehensive approach to looking at what happened," Schultz
said. <o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">In
February, the Legislature's Joint Legislative Oversight Committee voted to
conduct a performance audit to examine just why Molina's claims processing
system went so awry. Tuesday's report was the result. <o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">Auditors
found improvements in the interim, including when Molina doubled its support
staff and enacted other remedies to reduce pending Medicaid claims to fewer
than 40,000 in February, from more than 120,000 last September. But more work
is needed, they wrote. <o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">"Providers
continue to express concerns that progress is not being made quickly enough,"
the auditors said, likening the failure of Molina's system to the 2005
collapse of Idaho's proposed computer system meant to track public school
students' academic progress after $21 million had already been spent on that
project. <o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">Lessons
learned by that financial flop weren't applied when Idaho brought Molina on
line, auditors wrote - despite the obvious importance of a seamless transition
for a system that handles 150,000 claims or more every week.
<o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">"The
challenges associated with the transition were not simply a series of
unpredictable events," according to their report. "Instead, we found these
challenges were the result of unclear contract requirements, a lack of system
readiness and the absence of adequate end user participation throughout the
enrollment and testing phases." <o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">Dell
Bell, Molina's Idaho account manager, spoke only briefly at Tuesday's session,
indicating the company agreed with auditors' findings. <o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">Lawmakers,
meanwhile, reserved harsh words for Health and Welfare officials in charge of
getting the matter under control. Sen. Dean Mortimer offered this tongue
lashing when Health and Welfare's Schultz expressed "anxiety" over collecting
the outstanding interim payments: <o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; MARGIN-LEFT: 0.5in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">"The
taxpayer expects us to go beyond that, and actually fix it," said Mortimer,
R-Idaho Falls. "To me, anxiety is not the right answer in this situation."
<o:p></o:p></SPAN></P>
<P
style="LINE-HEIGHT: 10.5pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto"
class=MsoNormal><SPAN
style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #333333; FONT-SIZE: 10pt">_________<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="COLOR: #1f497d">Saundra
Lund<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="COLOR: #1f497d">Moscow,
ID<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="COLOR: #1f497d"><o:p> </o:p></SPAN></P>
<P class=MsoNormal><SPAN style="COLOR: #1f497d">The only thing necessary for
the triumph of evil is for good people to do nothing.<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="COLOR: #1f497d">~ Edmund
Burke<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="COLOR: #1f497d"><o:p> </o:p></SPAN></P>
<P class=MsoNormal><B><SPAN style="COLOR: #1f497d">***** Original material
contained herein is Copyright 2011 through life plus 70 years, Saundra
Lund. Do not copy, forward, excerpt, or reproduce outside the Vision
2020 forum without the express written permission of the
author.*****<o:p></o:p></SPAN></B></P>
<P class=MsoNormal><o:p> </o:p></P>
<P class=MsoNormal><SPAN
style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 8.5pt"><o:p> </o:p></SPAN></P>
<P class=MsoPlainText><o:p> </o:p></P>
<P class=MsoPlainText><o:p> </o:p></P></DIV>
<P>
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