The State of Connecticut recently put into effect a new system designed to provide better monitoring of in home care services agencies throughout the state provide. While a few agencies are fighting this new system in court, claiming it removes private controls from these independent businesses, there are some problems emerging, especially with regard to payments.
A recent survey of about three-quarters of the home care agencies throughout the state that provide services covered by Medicaid services claim they haven’t been reimbursed yet, to the tune of approximately $1 million. However, that number may be higher, given that not every agency responded to the survey by the deadline for the article referenced below.
According to a Hatford Courant article, Advocates: State Owes $1M In Unpaid Bills to Home-Care Agencies Serving Medicaid Clients, written by Josh Kovner:
“The health-care association polled home-care agencies earlier this week and asked, among other questions, about delayed and unpaid claims. Thirty-nine agencies responded as of Friday morning. They service 7,200 Medicaid clients, 45 percent of total client pool of 16,000.
Based on the survey results, Tracy Wodatch, a registered nurse and vice president of clinical and regulatory services, said, “The association is aware of over $1 million in held claims due to processing issues, but there is likely far more than that across the provider population.”
Processing ‘issues’ can cover a wide range of topics, not the least of which involves government handling of these repayments or reimbursements. There are approximately 400 agencies providing care throughout the state. While this may seem to be a small problem, when agencies do not receive reimbursement for services already provided, given that many of the smallest agencies operate on razor-thin profit margins, it makes it difficult for them to continue providing these services, paying their home care aides and other providers for the work they do, and even remain in business.
The association hand delivered a letter to Governor Malloy explaining the problem and their concerns. They also discussed a system that has numerous problems, making it difficult for members to even gain access and due to many manual controls, it adds clerical costs to these agencies, which they can ill afford.
A Department of Social Services spokesperson refuted the claim and stated the department has already paid out $16.5 million for over 166,000 home visits. DSS is investigating this claim and also note that as the system is new, adjustments and corrections are to be expected.