Computer Error Creates Payment Issues for Maine Medicaid Program

On Wednesday, Maine Department of Health and Human Services Commissioner Mary Mayhew announced that the state likely will have to refund the federal government after a computer error led the state to erroneously provide Medicaid benefits to about 19,000 residents who had become ineligible for the program, the Portland Press Herald reports (Richardson, Portland Press Herald, 3/7).

MaineCare, the state's Medicaid program, receives two-thirds of its funding from the federal government.

Details of Computer Error

According to Mayhew, the computer system used to pay out claims for MaineCare has had several problems since its launch in 2010. For example, she noted that the system never was designed to exchange data with a separate DHHS computer system that tracks eligibility.

In September 2010, DHHS sent letters notifying about 19,000 MaineCare beneficiaries that they had lost eligibility in the program.

However, those beneficiaries continued to have active MaineCare cards because of the computer error. Many of the residents used their cards to continue making doctor's appointments and obtaining other health care services (Farwell, Bangor Daily News, 3/7).

Next Steps

Mayhew said that officials will conduct an audit to investigate the claims problems. She added that if the audit determines that claims were paid improperly, "there will be a requirement to pay those funds back."

According to Mayhew, it could take up to a month to determine the amount of money paid out improperly (Portland Press Herald, 3/7).


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