Molina Meets with Medicaid Providers, Governor Otter About Payments Issues

Press Release

Governor C.L. "Butch" Otter came away from a meeting with the head of Molina Healthcare Inc. and the director of the Idaho Department of Health and Welfare more confident that the contractor and the agency are working together and with providers to see that problems with payments to thousands of Idaho Medicaid providers are addressed quickly and completely.

"I'm not here to make excuses. First of all I want to apologize to the providers who have had problems, and to the State," Dr. J. Mario Molina, MD, president and CEO of Molina Healthcare, said at a press conference after meeting with Governor Otter and Health and Welfare Director Dick Armstrong. "We are very committed to do what is necessary to fix the system. We have weekly meetings with the Department and providers. … You have my commitment that we will devote the time, energy and resources that are necessary."

"I asked Dr. Molina to come here today to meet with providers face to face, and to explain to me personally what happened and what's being done about it," Governor Otter said. "I feel a lot more comfortable now that we'll get where Dick Armstrong said we would. But I also let both he and Dr. Molina know that I'm holding them accountable for continuing that progress and working closely with providers. I don't want anything to interfere with Idaho Medicaid patients getting the care they need."

Serious problems quickly arose after a new Medicaid claims payment system was implemented, resulting in non-payment for services to many Idaho Medicaid providers. Director Armstrong ordered extra payments to providers while problems with the system were addressed. He also asked Molina to conduct a thorough evaluation of the system and present a corrective action plan to the State.

Molina's evaluation showed that the system itself is sound, but it was understaffed for system startup and training of staff was insufficient. Molina committed an additional 48 people to remedy the problems, drawing on its resources from operations in nine other states. On Monday, Dr. Molina said nearly 200 people now were working on Idaho's issues, up from about 100 people a few weeks ago, and Director Armstrong said things were moving in the right direction.

The Medicaid claims payment system pays approximately 100,000 Medicaid claims a week that averages $24 million in payments to Idaho Medicaid providers. The federal government required the state to replace the previous system, which was more than 10 years old. The contract for the new system was awarded to a division of a company called Unisys, which spent two years developing the complex claims payment and information system. Molina Healthcare acquired the Unisys division and the new Idaho system on May 1, one month before the system went live.

Dr. Molina briefed Governor Otter and Director Armstrong on his meeting earlier Monday with representatives of some of the 11,000 Medicaid providers who serve more than 200,000 Idaho patients. They outlined their concerns and discussed Molina's plans for addressing them. Dr. Molina said the meeting with representatives of the Idaho Medical Association, Idaho Hospital Association and Idaho Health Care Association was "useful and productive."

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