MaineCare MECMS Continues to Struggle
The MaineCare MECMS system was back in the news this week, with both positive and negative news to report. Read the article below to see what transpired at the bi-weekly Provider Advisory Committee meeting and for a report on what to expect in the next few weeks if you are a MaineCare provider.
There was both positive and negative news this past week on the MECMS front. On the positive side, claims in suspension were under 182,000, a marked improvement from the last few weeks. The weekly metrics showed that the system was processing new claims at 91.9%, with 17.6% denied. The ten new provider relations staff have completed their fourth week of intensive training and will be in the field soon. With the new staff, it is expected that the Office of MaineCare Services will be able to do more provider education sessions around the state. The OMS would welcome meetings with various specialties and will begin with a meeting with the Maine Society of Anesthesiologists at MMA on the evening of Sept. 20.
On the negative side, the results of Release 1, which was deployed on July 1, 2006, was mixed and has delayed the scheduling of the remaining 4 Releases. Originally, the fix to allow for electronic processing of the Part B cross-over claims was part of Release 2 due for deployment on Sept. 1. This will now be delayed with a new schedule of future Releases to be provided by MaineCare officials next week.
In addition, Kirsten Figueroa, Deputy Commissioner of Finance, DHHS, described an aggressive plan to recoup all the remaining interim payments by the end of the state's current fiscal year (June 30, 2006). This will be attempted despite the fact that it is now clear that the MECMS system will not be fixed until later in the year and perhaps even into next year. MMA representatives objected to a gobal recovery effort if it applied to physician practices whose claims were not being processed accurately or for any physician practice still owed funds from the Part B cross-over claims. These claims are being processed on paper but the MECMS system is not presently able to pay these claims electronically. MMA staff met with Governor Baldacci on Saturday and learned that as a result of a meeting on Friday with Commissioner Wyke, Ms. Figueroa and the Governor, the recoupment of the interim payments may be slowed down. Once this is confirmed by MaineCare officials, readers of the Weekly Update will be notified.
In addition to the delays, the OMS sent a communications to all providers this past week noting an error in processing that was causing a number of claims to be rejected. Further information should be sent out on this latest snafu this coming week.
The Augusta area newspaper the Kennebec Journal recently republished an updated version of the article on the MECMS fiasco from CIO magazine. The three part series ran on August 13, 14 and 15 with MMA Pesident-elect Kevin Flanigan interviewed for the final article. The original article is on the MMA website at www.mainemed.com.
The next MECMS Provider Advisory Committee meeting will be held on August 31. MMA has asked that the issue of the $1 million appropriated to reimburse providers for some of their MECMS-related costs be added to the agenda.
MMA is expecting either Commissioner Harvey or Deputy Commissioner Hall to be present at the MMA Annual Meeting to discuss the current status of the program. Their presentation would be on Saturday morning, Sept. 9, as part of the General Membership meeting.