Sherman provides MaineCare update

    AUGUSTA — “I have received a number of inquiries concerning computer problems at DHHS,” stated Sen. Roger Sherman (R-Houlton). “I want to reassure my friends and neighbors that the problems have been identified and work is progressing toward a solution.”
    With the computer problem, as with communications between individuals, this was a communication error between computer systems. Departmental leadership learned that the systems that determine Medicaid eligibility and the new claims processing system were not communicating properly, and hadn’t been doing so since September of 2010.
    As a result, people who were notified that they were no longer eligible for MaineCare, were still able to receive benefits if MaineCare was continued to be billed for services. 
    Commissioner Mary Mayhew is working to fix the computer systems and also quantify the money spent on ineligible claims. To that end Commissioner Mayhew is meeting daily with a multi-faceted team, including leaders from DHHS, State Controller’s Office, and Department of Administration and Financial Services. They have well-defined goals, including completing the financial analysis, analyzing the process to determine where the system or process broke down, update the “fix” of March 10 to present, make sure that cases are properly closed going forward, mapping data from beginning to end to ensure accuracy and consistency throughout, develop “best practices” that apply to eligibility determination and claims payment, and a comprehensive risk analysis that includes work priorities.
  For more information, contact Sherman at (207) 287-1505 or e-mail at SenRoger.Sherman@legislature.maine.gov.