AUGUSTA, Maine — As officials work to nail down how much a Medicaid computer error will cost the state, the problem’s potential scope has widened.
The Department of Health and Human Services originally estimated that the error led the state’s Medicaid program, known as MaineCare, to continue paying medical bills for up to 19,000 beneficiaries after they lost eligibility through the end of last year. A March 30 report by a working group looking into the bad payments refers to an additional 5,300 people who mistakenly received coverage from Jan. 2 to March 10 of this year.
The computer system that pays MaineCare claims doesn’t communicate properly with a separate system that tracks eligibility, according to DHHS officials.
The group sorting through the problem includes DHHS Commissioner Mary Mayhew; State Controller Terry Brann; Chief Information Officer Jim Smith; the payment system’s vendor, Molina Medicaid Solutions; and a subcontractor, Goold Health Systems.
DHHS anticipated that additional recipients would be added to the mix, Mayhew said Wednesday night. The billing system undergoes regular fixes to address a long list of problems dating to its implementation in September 2010, she said.
One of those fixes finally closed the 19,000 cases in early January, Mayhew said.
“That fix was only able to close the cases retrospectively,” she said. “As we continued to receive feeds from the eligibility system, that same core issue still existed.”
The working group is expected to brief the Legislature’s Appropriations Committee again on Friday. Late April has been set as the target date for attaching a dollar figure to the MaineCare payment error, Mayhew said.
The financial impact of the additional 5,300 recipients will be assessed separately, she said.
“We are looking holistically at the entire system and the connection with the eligibility system and re-evaluating all of the current priorities and issues that need to be addressed in the system,” she said.
Beginning in September 2010, some MaineCare recipients were sent letters notifying them that they had lost eligibility but MaineCare cards remained active for those ineligible recipients.
Beneficiaries can cycle on and off the program as their personal circumstances change, such as getting a pay raise or signing up for private insurance.
In cases where these patients went to the hospital or used other medical services, MaineCare erroneously picked up the bill. The bad payments went to health care providers, not to individual recipients.
Mayhew has said providers had no way of knowing which patients no longer were eligible for MaineCare.
The problem, dating back two years, has inflamed partisan discord in the Legislature. Democrats have called for an independent investigation of DHHS, accusing administration officials of covering up the problem while the Legislature was considering painful budget cuts earlier this year.
Republicans have defended Mayhew, noting that the MaineCare computer problems were passed on to the LePage administration after plaguing the administration of Democratic Gov. John Baldacci.
The annual state audit released Wednesday underscored DHHS’ Medicaid woes.
“The Department does not have adequate procedures to determine individual eligibility for the Medicaid and [Children’s Health Insurance] programs, to maintain records relevant to making eligibility determinations or to charge the appropriate program for the associated costs of eligible individuals,” the report reads.
“There’s clearly some lack of functionality that needs to be addressed and should be taken seriously,” State Auditor Neria Douglass said Wednesday.
Similar findings about eligibility determinations have been noted in audits each year dating back to 2005.
“Often in these cases, particularly with DHHS, we find problems and there’s an agreement there’s a problem and they say, ‘well we have a system that’s going to fix that next year,’ and then we go in and next year it’s not fixed,” Douglass said. “Then they have another new procedure for correcting the issue. It will be good when we finally get them corrected.”
Maine’s latest Medicaid billing system was implemented in September 2010 with hopes that it would make the payment troubles a thorn of the past.
“It’s still not working [fully], it’s not fixed yet,” Douglass said. “We can always hope for more.”
The audit, which covers the fiscal year ending June 30, 2011, bases its findings on actual errors, including improper payments, that occurred within a sample. It evaluates state compliance with federal programs. The federal government pays for roughly two-thirds of MaineCare’s costs.
The audit does not judge the performance of state agencies, which is the domain of the Office of Program Evaluation and Government Accountability.
oh mary mary quite contrary… give me some scrilla
They knew this 3 weeks ago, they were just waiting to break it. Which is, of course, part of the problem with this administration. They are lying to us while they are denying that they lied.
They knew about this when Baldacci was Governor.
Yeah and it was Bush’s problem also:)
Like so many of the Democratic Liberals that post on the board, “change the subject” lol
I am not sure what your point is. You state that the fact that this new system didn’t work was known back when Baldacci was still in office, how can you say that on one hand and then absolve the current admin for not “knowing” about a known issue? Its an odd thought pattern.
I do not absolve anyone of the issue. Though the fact is, since this was known during and after the Baldacci admin. then the Legislature already knew of the problems. With the possible exception of new Legislators. No more than you can absolve Bush with some of his problems, or Obama for continuing on with expanding the deficit.
If it was already known during Baldacci (and I’m not convinced Baldacci DID know), and LePage continued to carry on as normal, then LePage is complicit. You would think he’d have the intestinal fortitude to fess up.
That would be a first.Judging by the size of his intestines,he wouldn’t miss it.
But nobody covered it up…
I wonder, how long had it actually been going on?
This new system went in Sep 2010. It started then.
Both systems? Supposedly there are 2 systems that can not communicate with each other properly. I was just thinking, sounds like the Democrats and Republicans.
The eligibility system, ACES, was on line long before the new payment system was. ACES works fine and has been a model for other states. The problem is with the payment system.
Then we must use a payment system different than other states? Or they are all in a mess. Though most are, not sure if it is with the same issue.
Bruce the eligibility system has been working since 2002 and the newest billing went online in Sep 2010. They do talk to each other, but not very effectively.
I would think the amount of people that “not very effectively.” is saying it lightly.
Bruce, the reason I said it that way is because if the systems didn’t talk at all, which some people are claiming, then the billing system would have zero information. All the pertinent info on cases comes from the eligibility system. So they obviously talk. There are a few glaring area’s where they don’t communicate well. If they didn’t talk at all, billing would pay no bills, since they’d have blank screens.
I am not apologizing for the errors or saying they aren’t huge and a horrible display, my comments are to shed more light on a few points that are misleading.
Thanks I appreciate shedding light on the situation, and I only know what is said in the paper as far as Comm. Mayhew as said or what was not said. Unfortunately I think some have blown the situation out of hand.
So the first end of the year purge of the ” inactive accounts” on the accounting computer was about the same time as LePage was open for business, right ?
Who did not update the “sales department’s” customer data base ?
I would have to agree Bruce that based on what we have been told this “systems incompatiblity” had to have originated during the Baldacci administration. Was one of these systems actually procured or put in place during his term?
But what I don’t get..is if Mayhew and LePage knew about that.and had absolutely nothing to do with the errors..why didn’t they blow the whistle right up front? Mayhews and the Givernor’s behavior suggests that this did in fact happen on their watch..why would they cover up such a huge and costly error of a prior democratic administration? Makes no sense.
My understanding (and I know someone on the board will correct me if it is inaccurate) that both systems were in place before LePage took over. How long before I do not know. I would of thought they would of look at systems in other states, or should of known if the systems were compatible. I am not sure how long the systems were in place, some of the ineligible people I would say would be carryovers. I think we all sit back no matter which party is office, do we really know what happened? Sometimes it is semantics as too , she failed to tell them, didn’t tell them whether on purpose or not. If the problem occured prior then why were they not fixing it already. Regardless of whose fault we want to blame now, both administrations are at fault. What needs to be done, the problem needs to be fixed. As to whether Mayhew made a mistake or tried to cover it up. I am very sure that it will come out in the wash, no matter what.
Bruce,
Thanks for this.
“We the people” don’t have to wait for any officer or the governor or any legislative body to do what we will to be done. Under Maine’s Constitution, we can determine what will be done via petition, not one of those credo or move on petitions that float around but via a proper petition in proper form signed by a number of citizens equal to at least 10% of the votes cast in the last gubernatorial election. Presentation of such a petition can over ride the governor or the legislature forcing a general vote on the matter.
If Mayhew lied to the Committee, we don’t have to wait for the Committee or legislature to take appropriate action. Same with the Governor. Impeachment is a possible action for both. The moment a lie is documennted for either, if the Senate fails to use its powers to impeach, we can compel that.
As a point of reference the Eligibility system has been up and running since 2002, the new billing system went “live” in Sep 2010.
Well, you know how they are. This should come as no surprise, given Lepages “transparent” government. If they’d told us 3 weeks ago it would have been too close in timing to the first DHHS bombshell. LePage, honest and transparent, or lie and mislead? I think most now realize it’s the latter of the two. But I guess lying is ok, we’ll just blame Baldacci. It’s his fault Mayhew and LePage are dishonest. Mayhew should come clean and tell all she knows in a legislative hearing. LePage will kick her to the curb, after he’s done using her as his “fall guy”.
He can’t kick her to the curb. He had to go to the end of the Earth, literally to find her. No one else will take that job.
Mayhew resigns in disgrace
Only to be hired a week later, back at her lobbying job.
So pay attention to who does that, and follow the money.
I agree with you on this. I wouldn’t be surprised if he isn’t asking her to stick around, as opposed to asking for her resignation.
Part of LePage’s problem is his inability to find people to work for him… which is yet another mark against his ability to BE a Governor.. if his style and demeanor are not ones that will attract talented and capable people, for fear of the bulling or the constant attacks against his policies that you’d have to support or defend…. it is not just his own abilities that are hurting this State, but his ability to find and recruit capable individuals.
“But I guess lying is ok ”
For some, to maintain their faith based political myths, as reality and the fact let them down.
I not only expect the 39% er’s lies, I’m encouraging them between now and November.
The Maine Constitution requires a balanced budget. On June 20, 2011 Maine’s Governor Paul Richard LePage signed a two year budget that amounted to $6.1 billion.
“I think that it is a budget that moves Maine forward in a very important way,” said Senate President Kevin Raye, R-Perry. “The largest tax cuts in the history of the state, meaningful welfare reform, essential pension reforms that will strengthen the pension system for years to come.” House Speaker Robert Nutting, R-Oakland, also praised the budget, saying it is a compromise that will benefit Mainers for years. “The $150 million tax cut for Maine citizens that takes 70,000 people and removes them from the tax rolls, and reduces the tax rates and helps small businesses, I think that is the keystone of this,” Nutting said. Sounded really good didn’t it? The tea party Republicans who controlled both bodies of the Maine Legislature as well as the Governor’s office practically fell all over themselves with joy at their fantastic accomplishment. There was just one itsy, bitsy, tiny problem………It was a fraud. Since that day in June of 2011 we have come to find out just how much of a fraud it actually was. We started hearing rumblings coming from Mary Mayhew of DHHS of a budget shortfall of approximately $70 million. The shortfall then escalated to $120 million. LePage demanded that 65,000 of Maine’s most vulnerable citizens be dropped from Mainecare. He attempted to bully the Appropriations Committee for a fast vote. He even threatened to close Maine’s schools. When the Committee requested more information LePage and Mayhew stonewalled saying that the Committee had all the information it needed and again demanded a quick passage. Within days of the legislature passing an “emergency” budget Commissioner Mayhew informed the legislature that she had uncovered a problem of Mainecare paying for services to 19,000 people who were ineligible for the program. She later admitted that she had known about the problem during the Appropriation Committee’s deliberations, but had failed to inform them of the problem. Now we find out that there are 5,300 more ineligible people on the program. It gets better yesterday Maine’s Finance Commission Millet informed us that $14.3 million magically appeared. That little hiccup was blamed, if you can believe this, on a dead person. Does anyone in the LePage administration know how to add and subtract? Or is it a case of total incompetence or even worse could it be deliberate?
LePage is going to cost Kevin Raye his shot at being a U.S. Senator if he doesn’t wise up in a hurry. Not that he has much of a chance now anyway.
Especially when Raye isn’t running for the senate, but the 2nd district house seat against Michaud last I read.
As far as I’m, concerned, the big tax cut was part of the plan to create these budget shortfalls so the gov and r’s could implement their draconian social platform. Give tax breaks to the rich and big corporations and blame the poor so they can cut the social services, weaken unions , and divert attention to their incompetence by blaming the previous administration.
Good insight. Of course it was (is)!
I doubt it, but if it was then I’m tickled pink. It’s high time we kicked some of those gimme-gimme types out of the wagon and made them push, instead of steer, for a change.
So. You don’t like liars and cheats. Unless it helps your bottom line? Very kind of you. If the tax cuts were a way for the admin to say “see how broke we are, we need to cut all this stuff”, when in reality we aren’t really that broke, you’re ok with that kind of lying and cheating? Pragmatic of you. I just guess its a damn fine thing that we “found” $14million before we made any other cuts.
Actually it sounds like we made the tax cuts $14-million too small.
“Government is like a baby. An alimentary canal with a big appetite at one end and no sense of responsibility at the other.” Ronald Reagan
Why not start with the corporations that run the smart ALECs and the Heritage Foundation, then ?
If Paul wants to take away their EBT cards, that works for me. I didn’t realize they had any.
What would REALLY put a smile on my face is reclaiming the $235-million plus siphoned off by Joe Brannigan’s Shalom House, Arthur Lerman, Brenda Harvey’s hubby, Joe Bruno, Bobby Nutting, Steve Minkowsky, Dale McCormick, Adam Lee & his sister. Maybe even the $56-million that ‘disappeared’ on Brenda Harvey’s watch due to ‘computer problems’.
If we could eliminate all the professional pigs and party parasites that feed at the public trough, we could probably eliminate the income tax completely.
That wouldn’t work for you, though, would it? You see the income tax as a way to PUNISH those who get up in the morning and go to work in the Dreaded Private Sector.
”
If Paul wants to take away their EBT cards, that works for me. I didn’t realize they had any.”
Not very imaginative are you ?
That is fine.
Just so long as other people know you can’t hopw two different thoughts in mind nor connect the dots.
It is not important to me that you understand how … aaaaah, err…
defective your thinking really is, just so long as others are warned about it.
Very well said.. This is what the Grover Nordquist plan is designed to do.. This is what i have been saying all along. Very well said..
Good job getting into ALEC’s offices and downloading their position papers!You’re right on the money.
Makes sense, honestly. However there is one minor flaw in this theory: Its assuming that LePage is clever enough to do this. But hey, maybe it was someone else’s idea.
Its the ALEC playbook. Ever seen a playbook? Tells you exactly what to do.
LePage is just a tool.
He is being run by outta State interests, which is his employment history before working for the damage good stores, isn’t it ? He was the local hatchet man for paper company’s, power companies and Canadian corporate interests wasn’t he ? He is not as smart as the think tanks that he fronts for… they know and expect that, too.
Shock Doctrine. For the win. (Well, if you consider the outcome a win, that is.)
I want to what they think a conservative victory is.
Clearly, it’s not a better preforming State Government, yet.
I agree and it does my heart good to hear that from The County, where there are still loyal Americans who can compromise but who always vote Republicans, too.
I don’t care about your personal politics, per sey, whatever they might be, sir,
but given that they are your neighbors up there, I would … must… ask you how best to say to the good people who have always voted GOP because it was once the Party of Abolitionism, the Union, and Prohibition (but are so disrespected as RINO’s now? ) that the GOTea Party does NOT represent their good values, as I have always understood them ?
It is not on topic here, so much, but it is increasing important, as each day before the second Tuesday in November passes.
In short, I love you speaking out with that nick, and am bumping the bet in general.
What, IYO, works best to wake up ” the RINO’s” who really are being most disrespected by the new GOTea Party ?
I guess another way of saying the same might be; please, given your position, can help us find the middle ?
If they can hear your point, above, that is very encouraging.
You left out the part where they tried to ram through legislation to give ant surpluss moneys to the rich in tax cuts. Maybe they knew something we didn’t when that was proposed.
What are these tax cuts to the rich you speak of? Are you suggesting that if you fall in the top tax bracket with a taxable income of $19,950 than you are rich?
Thanks for this excellent recapitulation. I agree. Smells of outright fraud and cover up. Time for some subpoenas or something. The Attorney General should have been on this ages ago.
From Maine.gov: About Attorney General William J. Schneider
Attorney General Schneider is a career prosecutor, a retired U.S. Army officer, and a former Assistant Republican Leader in the Maine House of Representatives.
I’m doubtful this AG will be looking into any of this.
Yes that is one of the major reforms Maine should institute. The attorney general should be a “people’s attorney” not a creature of the senate..as in Maine.
” We the people” should get up a petition to require that the Attorney General be an elected office and redefine the duties of that office using a state like New York or California where the attorney general has been key to rooting out corruption and crime in the public and private sector.
Also Maine needs an Investigator General System..a totally separate indepedent system with authority to investigate corruption in any governmmet agency, on the part of any elected or appointed official.
These two changes would really help to prevent problems like this. Someone in DHH who knew about this ages ago could have reported it to the IG in complete confidentiality and it might have been nipped in the bud.
“we the people” invoking our power under the constiution can bring these two reforms about via petition and referendum. We don’t have to wait for anyone else to do it for us..
It appears to me that you have been paying close attention. Maybe the adin should hire you. I think another pair of hands should have informed the providers And patients by email or letters. Computers need workers to process the communication.
We are learning of just how badly Maine has been mismanaged by democrats for the past 40 years and while LePage has made a few mistakes, he’s barely been there a year. Its hard to pin this all on him even though I realize full well that he is the governor of Maine right now. I hope that you hold yourself to the same high mistake free I’ll take the responsibility for everything standard that you expect from LePage. Personally, except for a few misspeaks, I think he has performed exceptionally since he took office.
As an aside, I like how you add Richard on your daily rants, it adds quite nicely to the drama.
No it’s Kings fault… No wait its Jocks fault… Oh how bout we blame it on Brennan… Well since we are passing the buck around lets settle on calling it Gov. Baxter’s fault. LePage is the current resident of the Blaine House. This is his fault, even if he had nothing to do with it, just like Clinton gets credit for the economic boom, whether he had anything to do with it or not, he was running the show when it happened. Same here, it’s LePage’s fault. What makes it even worse is LePage’s contempt for the poor, elderly, and mentally ill make this look all the more like an intentional omission in order to get the cuts he wanted at DHHS. This is politics, it doesn’t matter what it is, it matters what it looks like.
“We are learning of just how badly Maine has been mismanaged by democrats for the past 40 years and while LePage has made a few mistakes, he’s barely been there a year. ”
ROTFLOL
… so just imagine this mess times forty.
But you must be a great fisherman and a low handicapped golfer, too.
I love how well you sandbag.
So just put me down for being on par, too, okay ?
: )
4mermainer,
Just ran across this interesting analysis that puts your recapitulationn in a much larger context that actually makes many of the points you make really leap
out.http://www.edlegg.com/Capitol_Notes.html
I don’t know Ed Legg, the uathor but his broader context offered seems to jibe with other sources that I know to be credible. His analysis focuses on Le Page’s choice of Mary Mayhew and what her skilss as a lobbyist were..evasiveness, slipperiness..and what her skills for this job weren’t..any relevant expereince in agnecy administration of any kinnd and absolutely no background in Health and Human Services. Sinnce LePage focused first ad with a vengeance on totally dismatntling and shrinking DHHS his choice of Mayhew and is defense of her now is very clear.. he wanted someone slippery at the healm who could fend off inquiries and carry out his butchering of the agency.
He also points out the auditors report I just mentionned in a reply to Sally below. It was a broad report on many agecies but as Steve Mistler notes inn his excellent arricle in the Sun Journal on this which establishes that MaryMayhew had to have straight out lied whe she said she first became aware of this in January of this year. If that is true..that is impeachable and if the Senate doesn’t take that up as their duty, “we the people” should via peition as provided inn the Miane Consitution.
It seems very possible the Governor also straight out lied.
Both the Governor annd Mayhew should be put under oath before the senate and asked these questions and the Senate should use its powers to acutally obtain documents. If they try that there will be witnesses and tey will be found.
If they lied Mayhew and the Governor will have done their best to destroy all evidence of any knowledge of thi prior to January 2012 but via other sources there will be copies or witness to verify. I think the senate should immediately seize with appropriate warrant all the Governor’s files and all Mayhews files on this.
I can’t help but think they did know. I mean this was and has been the worst kept secert in Maine. The new system went in back in 2010 and soon there after news outlets were reporting on the fact that it wasn’t working properly. Baldacci admin requested an urgent fix and that was in the process at time of switch over. To then turn around and claim that they didn’t know of any issues, is really, really hard to swallow.
Mayhew’s timeline of events is a bit too close for comfort as well.
As for putting them under oath, I don’t see that happening. Even if the D’s get back the house and senate next year.
Thank you for your brilliant investigative work. You are the most probative and powerful voice I have ever seen in these forums. Some of your posts are legendary, and this one is among them.
And what a mess this is!!–I have wondered what was supposedly wrong with the computers that were supposed to send out letters to the people that were no longer covered under MaineCare—I’m sure the answer will be that they were “lost in the mail”! A whole lot of folks didn’t know they had been cut until they tried to pick up prescriptions at the pharmacy. We hear every year that DHHS is very short on a lot of funds, but we never hear if they have ever been found!–Some one must have the answer to that , but I guess it’s a secret!–And don’t you love all the threats the Man makes if he dosen’t get his way??–And this bully has the gall to call someone else a spoiled brat??–It all comes down to who you know, and where you work!!–And every one but the guilty will be blamed!
“The Maine Constitution requires a balanced budget. On June 20, 2011 Maine’s Governor Paul Richard LePage signed a two year budget that amounted to $6.1 billion.
“I think that it is a budget that moves Maine forward in a very important way,” said Senate President Kevin Raye, R-Perry. “The largest tax cuts in the history of the state,…”
No contradictions there, to the morally deluded.
Nor any question of whose back this supposed baa enced budget is upon.
The political faithful won’t notice one, anyway or how fast the point changes from balancing the budget to tax cuts, anyway. They are not the same thing, I some people, at least, realize.
Besides the GOTea Party controls the State, this year, so show us one, when this administration, which does not even how much it has, or how it owes the Federal Government, can write any real budget.
Anyone who believes you can balance the budget and cut taxes deserves the GOTea Party.
Glad it is just a 39% minus the good Republicans who know how to compromise, sometimes, minority, huh ?
They only have a short time, until November, to show us it is supposed to done.
Real politics are hard that way.
Sorry Charley.
Time to say goodbye to Mary and her band of thieves. She is only sorry because she got caught.
Has the Governor gone on vacation again, i understand he is now visiting in Canada where he hid during the draft period:) Oh, the draft from his big M#$%%^.:)
How many vacations has he had in comparison to Obama? Yet I never see any complaints about that.
If you want to show people you actually have some credibility you need to be willing to be truthful in your comments. But in case you did not know, this story has been debunked on many occasions. I understand you don’t like LePage (probably because you are a career welfare recipient and this may force you to get a job) but at least try to be credible.
ya and we are not paying for his kid to go to mexico with her friends and the 25 secret service guys that WE ARE ALL PAYING FOR! the money obama has blown on his family vacations that we are ALL paying for is crazy. at least lepage and his wife get up in the morning early and work countless hours unlike we know what happens in washington. that is a joke. give me a break.
How, many time has mrs obama, taken trips with friends, and her kids, and at what expense, and no complaints, did she take like 40 friends to spain?? not one complaint for you guys then.
I find it hilarous that you think taxpayers paid for her friends to go to Spain. Taxpayers paid to protect her while she was there. How’s about just a little bit of common sense?
That does do the political hatchet job, but letting the clowns make this about POTUS vacations, pretending Bush was not their guy, is not getting to Maine’s need solutions either, is it Pfft ?
Indeed it is not. Once more people get on board that extremes on either end of the spectrum, is not where this country needs to be, perhaps we can heal the country, and also the state.
Come on Jed, you’re talking about the first lady of the Country. Protecting her from terrorists or kidnappers isn’t unreasonable. Why don’t you move a little closer to home and explain why we pay so many State Troopers for Executive protection, plus have to hire an additional uniformed trooper to stand outside his door to protect him from the citizens and those nosy press people. Honestly you’re comparing a world known political figure head to a chubby Governor from Maine! And why not questiion why we paid for the governor and his wife and their protection staff to go to business meetings in D.C., but skip the meeting and go to dinner and come home a day early instead. What a waste of money.
LePage’s wife lives in the family home on Florida.She only comes to Maine for special occasions. I doubt she “gets up early and works countless hours”.
Disqus generic email templatewell guess again cause I know for a fact
Still less then Bush. Also is Obama the one we are talking about? The reason we can’t get anything done is because if a problem comes up both sides say LOOK THEY DID IT TOO!
Something smells like flounder, would you like some cheese with your whine?
For all the whining you do, can you spare any?
Typical Republican, wants a handout.
If we are judging political leaders by the amount of vacation time they take (or don’t take) that would make Bill Clinton the best president of the modern era (as he took the least amount of vacation days), and George W. the worst (as he took the most)
Clinton did not need to go anywhere for a vacation as all he needed was in the White House (this would be referred to as interns).
If you haven’t seen anyone complaining about Obama’s vacations, you are legally blind.
But just for the record, he would still need to double his vacations to match what Bush II had at this time in his Presidency.
Of course his eligibility for the draft ended long before he went to Canada to work. Carry on.
Pulled comment…Trying to be nice.
well then send him your resume since you must know how to fix it. got caught? got caught doing what? trying to fix the problem? you couldn’t pay a person enough to take that job right now and the mess she inherited from the previous administrations! why not just focus on fixing the problem. maybe you can help if you have the expertise. they need all the help they can get. it will benefit us all when it does get fixed!
“you couldn’t pay a person enough to take that job right now and the mess she inherited from the previous administrations! ”
Well, okay let’s run with that . Then why was it better not to leave the old hands in place ?
When it clearly is his doing, can we blame LePage for not being a very good governor, or even a smart politician, yet ?
Disqus generic email templateyou must only read the paper once a week. get up to speed this and you might figure it out on your own.
“The problem’s potential scope has widened.” How many of us think that this quote is something we can expect to read over and over again as long as LePage and crew is in charge?
Okay, let’s all agree, regardless of the administration, the computers at DHHS are in need of some serious overhaul.
‘t’aint the computers that’s the problem; might be the people running (or not running) the place!
Actually, its the computers. This issue has nothing to do with front-line workers. For instance Eligiblity workers enter and do their work in one system, with the understanding that the info they put in will feed over to the Billing system. It is hardly their fault if it doesn’t. And since Eligibility can not see the Billing system, they can’t find that out until an issue is brought to their attention. For Billing workers, they can only see what fed to their system, they too have to work under the impression that their computer is working correctly. This is a management problem, plain and simple.
Have you seen the schematic for the computer system? I think it was designed to do what it is doing. This system has not done the job correctly (I don’t mean doesn’t function as designed/set up) since it was installed…at a huge expense to the state. There is a program in there, somewhere, that is creating the fraudulent payments. And, since the problem seems to be found and addressed and then new ones crop up, it might be that kind of a design feature. If it is blocked in one attempt, it searches out another attack.
An audit of the DHHS is in order first!
Maybe the feds should take DHHS over under emergency scenarios so providers and recipients can get paid.Not sure what the rules are on that but something’s rotten in Denmark.
Who wrote the program, so that it did not talk to the other computers??
They do talk, what they don’t do is talk effectively. If they didn’t talk at all, then the Billing system (from Sep 2010) would have zero information in it, as all the info that system has comes from the Eligibility system. Some things work fine, some things have never worked.
Who is the Governor of The State of Maine now?
From what we’ve seen over the past year, apparently NOBODY!
@StillRelaxin… I love it! That’s great…. really funny! @4mermainer, you are so right. Every time LePage does anything improper the answer for his supporters is to point out the past flaws in other people, other times, other situations… yadda yadda ya. People attempt to justify every screw up on the theory of two wrongs make a right. I’m not agreeable to this. Every Governor owns his own decisions – right or wrong and it’s not okay to make poor decisions just because the other guy did it. Didn’t anyone learn anything from their mothers? How about this… does this sound familiar? “Just because Johnny did it doesn’t mean you should. Would you jump off the Brooklyn Bridge just because Johnny did?” Well this is the approach LePage supporters continuously take to justify every one of LePage’s screw-ups. It’s so ridiculous.
What politician do you know that doesn’t point at the other guy?
If you watch any of the talking heads out of the White house that is the Mantra.
“Well we inherited”
Still. four years later they’re STILL saying it every chance they get.
Watch any network,Any Sunday morning show. Without a doubt both parties do it but holy cow, these guys never met a question they could answer.
I’m not a fan of Obama but no one can deny that he came into office in the middle of an economic disaster (not that’s he’s gotten anything done since then but… it was obvious this country was in crisis) . In the case of Paul LePage this situation was not inherited from anyone before him. This problem began in 2010… midway into Paul LePage’s term. There is a difference between blaming things on the prior administration when the problem existed at the beginning of a term and blaming things on the prior administration when the problem first started in the middle of his own term. But not enough of a difference to matter – being able to take responsibility for one’s own actions is a requirement for any leaders I choose. If they can’t live up to that I’m not going to roll over, justify a bad behavior and simply accept it. I’m going to be vocal and say I don’t like it and I don’t care which political party does it.
Just the same Baldacci’s administration isn’t being blamed for this… LePage is blaming DHHS, he’s blaming Republican employees who he said were afraid to come forward with the truth in 2010 because he claimed they were afraid of Democrats… really? Seriously? Afraid of Democrats when we have a Republican Governor, Republican majority in the House and Republican majority in the Senate? I don’t think that has a ring of truth do you? And… it has nothing whatsoever to do with any other politician other than LePage. He is responsible for his words and his actions. Plain and simple. Justifying bad behaviors, bad decision, etc… by blaming someone else may make it feel okay to you but it’s not what I want. I expect our leaders to minimally have the courage to admit to his own mistakes. I refuse to accept the excuse that “someone before me did it too so it’s okay”. It’s not okay. Two wrongs will never make a right. No political party or politician is ever going to convince me to become complacent or accepting of bad behaviors or force me to lower my standards of expectations for our leaders. If they can’t minimally take responsibility for all their own word and actions – good or bad then I’m going to be vocal about it. I don’t feel the need to simple accept it as the norm. Wrong is wrong no matter how many people do it.
Nobody but a bully.
A bully whose bully claim was the State Government should be run like business, but has failed on that count.
Once that has been noted, aren’t solutions the order of day for us adults, liberal or RINO, no matter which, to find the solutions ?
.
So let’s review, now that information that the Budget Committee asked for is now available ‘;
“One of those fixes finally closed the 19,000 cases in early January, Mayhew said.“That fix was only able to close the cases retrospectively,” she said. “As we continued to receive feeds from the eligibility system, that same core issue still existed.”
( like your accounting computer did it regular scheduled cleaning, and purged clearly inactive accounts)
So “Beginning in September 2010, some MaineCare recipients were sent letters notifying them that they had lost eligibility but MaineCare cards remained active for those ineligible recipients.”
(but no one updated the “sales department’s” customer data base,
which, naturally as SOP, is separate from the active accounting
program …)
May-be this is just a business management failure, Ms. Mayhew.
Given that business system computers are designed for business, perhaps you need to run your Dept. like one, as promised, if you can.
It is only natural that when a particular account changes its status,
such that the operation MUST communicate by letter to inform their clients of that change, that a computer system WOULD NOT close any such account, nor delete past customer account information without any active management input.
It is only natural that a well run business would manage all customer account information, even inactive account information, separately from “accounts receivable”, for planning and better customer service purposes, at the very least.
For example if a customer reaches his credit limit, who would want the computer automatically closing that account ?
That SOMETIMES means that they are a growing business and not only still a good customer, but a great one.
A real business solution would be that if you send a letter that you are closing one of your client’s accounts, have a authorized, responsible, human being which those letters in their hand, actually close that account, or at very very least flag it for closure on such and such a date, THEN post the letter.
Problem solved … on the front end, anyway.
But we still need to follow the money, too, don’t we ?
That coming from the blame Bush party.
Sorry Jed it is coming from a fed up Mainer. I voted not only for LePage, but for Bush twice. I just don’t think that locking into a flawed ideology of defending a politician simply because his or her views agree with mine is right. We as people, the ones who ultimately have to pay the bills, have to demand more from our politicians then having them blame problems that they could control on someone else. I guess my question to you Jed is why do you always assume that when someone doesn’t agree with a politician that they somehow fit into some nice neat package you can put a label on?
something has got to change before the state goes under no one is checking anything they are too busy blameing each other they need to work together to find solutions not just keep hiring friends and relatives and creating more cushy jobs for all but the working person
Yeah well MOST times if you need to get in contact with your DHHS worker they wont call you back until a week later. The DHHS workers have a HUGE case load. Instead of the computer errors, why dont they HIRE people who know what they’re doing???????????
At least their admitting there’s problems and trying to fix them. Most people just want to apply blame and point fingers.
Like the Baldacci administration?
Who cares about former administrations? Yes, Baldacci was a screwup, McKernan robbed the retirement system, and we could probably go on and on, but we’re talking about LePage now. Many don’t want to blame Bush for Obama’s problems, but will readily blame Baldacci for LePage’s.
baldacci was in there how long? 8 years and he could not get it fixed and you are cutting lepage up because he has brought the problem to light and has not fixed it in a year. sure that is fair 8 years vs 1 year. it is not whoose problem it is or was it is just that he is telling the taxpayers about it and wanting you to know what is going on. good or bad he is trying. no one is perfect and the people who make no mistakes are the people that do nothing. at least he is trying to get the best people the state can afford to fix the problem. it will get fixed just give him a chance.
Brought it too light? I’m sorry but the news was broke, he only started saying something after the news broke. That is why now one in congress new about it.
Disqus generic email templateit was actually brought up when baldacci was there and maybe even when king was there. this is not a new problem just one that is being more focused on by lepages counterparts. they have had issues for years and years with the dhs budget/
Why doesn’t this work for Obama cleaning up Bush & Cheney’s mess?
Typical GOP response, talking out both sides of your mouths!
If conservative can’t have it two different ways at once they have nothing.
Here, confronting their faith based political myths is a waste of effort, except for how it effects peoples thinkingg on the second Tues of Nov.
Let’s keep our eyes on the prize.
the only people that do not blame bush is the reps, the dems blame bush every day and still are, listen to your dem leader. All I hear every day when obama is talking about the problems of this country it was someone’s else fault.
Good point.
If you blame the past then you are just like those dang liberals, expect your Govenah keep screwing up.
So who got OBL dead or alive ?
Who does even know how much money the States has as he is supposed to be directing budget planning ?
That what the clowns are comparing.
Aren’t they just so cunnin’ ?
Baldacci did not cover anything up
No.
Like you 39%er , saying it must be Baldacci’s fault.
This is the classic example of the chimp which has it’s hand stuck in a jar because it has a fist full of gumballs, instead of letting go of the gumballs it smashes the jar as the solution.
Ain’t just like someone who would steal your Halloween candy, too ?
” …this refers to the Dirigo Healthcare Program. According to state budget
figures, tens of millions of dollars have been spent on Dirigo, and the
U.S. Census report from August, 2006, concluded that 141,000 people in
Maine lacked healthcare in 2005, up from 130,000 in 2004.”
So…..why didn’t you folks scream about this? Add in the computer problems on Baldacci’s watch and the figure is close to $75 Million. Posters were rabid about Lepage’s Florida home and his alleged $200 unpaid real estate tax.
I gotta tell ya, I’d be embarrassed to declare myself a Republican or a Democrat right now. I think Lepage is really trying to fix things and I can only imagine how difficult it must be to undo the total cluster**** this State Government has created over the years, but I respect him for trying. No way in heck would I ever take that job on.
All political issues aside, LePage is a bully and a liar. If I can’t trust him, I can’t respect a man like that, no matter what his political affiliation.
man oldboy3 you need help, every post i have read today from you is negative on lepage. he must have taken something from you or forced you to go to work for living or something. get over it, he was elected and instead of complaining about him, why don’t you try helping by giving him all the fixes since it sounds like you have them.
Here’s something positive: He vacations well and often.
Really? More than Obama? How many vacations has he had while in office?
Q: Has President Obama taken more vacation time than his predecessors?
A: According to one count, Presidents Ronald Reagan, George H.W. Bush and George W. Bush spent more time on “vacation” during their first year than President Obama did. Presidents Jimmy Carter and Bill Clinton spent less time on “vacation.”
http://factcheck.org/2010/01/president-obamas-vacation-days/
And this is import to Maine and this issue, why, besides he brought here for a weekend, and how much is that worth to Maine tourism ?
It’s just an answer to Kent’s question. I didn’t say it was important to Maine.
Yeah, he took something away from me, just like he did every other Mainer. He promised us jobs and transparency, and gave us lies and deceit instead.
Disqus generic email templatewait, let me call him and have him wave his magic wand just like barrack hussein obama promised us hope, change and properity! maybe they were both dreaming in color.
I find it truly, and I mean truly sad that you don’t know how to spell the POTUS’ first name, but knocked it out of the park with his middle name. Go you.
I find it telling he referred to his real problem in the last word of his post.
Here’s another positive thing, he’s making his administration a Family Business!!
Too bad he does not think of all Mainers as family.
If you said that against the President, you would still be called a racist.
Huh????? You been drinking some of Grannys tonic again Jed?
How ?
Please explain the connection in your mind.
amen regina! i am glad to see that there are still people in this state that can see both sides fairly. it is hard to fix these problems over night. baldacci was trying to fix some of these problems and he couldn’t either. it is a huge problem that they will have to keep trying their best to fix, no matter who is in charge, it just needs to be fixed!
Well said!
follow the coverup
And there is the problem.A good,smart,caring candidate doesn’t want he/she and their families to be dragged through the mud.So now you get ignoramuses who can have their strings pulled by the big money people.
This mess is due solely to LePage and his decision to fire or remove senior managers in DHHS and other departments and replace them with newcomers who did not know the systems. They may not be lying or trying to hide anything – they just don’t know what’s going on. Just as bad, but different.
DHHS may be the biggest problem right now, but there will be more. You can’t just fire and replace all the senior managers or reorganize too quickly and expect things to go smoothly. It may work at a junk store, but it’s bad management for complex organizations.
This mess started when Baldacci was governor, get your head out of the sand. The “senior managers” that were replaced had the same problems, we just weren’t told about their magnitude.
So you are saying, because the mess started before he took office, its not LaPage’s fault? Hummm….
We have always had huge shortfalls here in Maine for many decades but the huge DHHS/Welfare Expansion started by King is what is making huge mess for Maine Government. Until we can have the guts and start saying no more handouts for folks we are going to have these huge shortfalls. Maine taxpayers shouldn’t have to keep paying for these handouts for folks making a living off of Welfare. Start forcing them to head to the career center for a certain amout of time if they fail to meet those standards start cutting benefits.
Sure-send them to the CC for jobs that don’t exist.We are LAST right now in job creation and that is 100% under LePage.If I wanted a true government handout I’d just leave a big bag of unmarked $$ so my compliant R’s & T’s can give me another tax break I don’t deserve or need.
It appears that the majority of the posters on this forum seem to be blaming the Governor for finding the problems and correcting them. The “Blame LePage Firsters” are more concerned with playing politics than in making it possible for more people (Who are in need more than others) to receive allowable benefits. It is quite possible that those who seem to be crying the loudest are among those who stand to lose benefits to which they are no longer qualified, thus the crying and the whining.
Yes–but Baldacci did not cover it up
He didn’t???
If he didn’t cover it up then it is entirely possible that he appointed people who were either to incompetent or did not care to find the problems; or simply stalling the inevitable for political purposes.
This mess started in the middle of the King Administration made worse by Baldacci when he started messing with the computer system. He spent over 50 million dollars to upgrade the computer system and it hasn’t worked since. Liberals seem to forget this they always want to put the blame on someone else when it should be them for creating the massive Welfare growth we have here in Maine.
I think NE Voter is right.
The mess is because LePage cleaned house just as the system closed the books at the end of year.
You should not expect the customer data base to be effected by the accounting computer’s
purge of inactive accounts without the “customer service department” * supplying some human judgement.
Expecting that of inexperienced people who think all their clients are leeches committing fraud is not realistic, too, though, is it ?
* is that a part of how LePage’s Maine is open for business, or not ?
NE_Voter
Yes that makes sense to me..thanks. Did that in fact happen..did he strip all the key personnel from this program that he hoped to eradicate? That makes perfect sense..and I have seen this happen with reorganizations of agencies under new commissioners, mayors or governors. I think you may have nailed it. The consequence of uninformed fiddling with a complex structure.
Time to close dhhs down. Start new and get this thing under control.
That’s ridiculous…It’s time to hire someone that knows how to fix the problems.
We did.
He’s the govornor, and it WILL be fixed.
How can you fix anything when you are too busy covering it up?
It’s been going on now for 10 years.
Guess who UNcovered the mess.
Our new Governor.
Paul Lepage.
Actually, it was channel(s) 6, 8, 13 back in 2010. But why quibble with facts?
How can you fix what you don’t understand?
Cut something else!
Only if we start with competent, honest managers. How many of these are left in the LePage family, anyway? He’s already begun on his in-laws. Maybe nieces, nephews. Surely his aunts and uncles have a wealth of skills to bring to us.
>>>>>
Shh, you’ll spook her.
>>>>>
The mere fact that you think this is an option, fully illustrates how little you know about reality.
Governot lopage knows he’ll never be elected again. So If I were to have to take an educated guess, I would dare say that governot lopage along with his corrupt partners are stuffing their pockets taking full advantage of the DHHS fraudulent debt confusion. A fifth grader would be able to add, subtract and figure out who is eligible for Maine care. This number and eligibility scrambling, to me is a sure sign of convenient fraud and corruption, thus enabling lopage to be able to stuff a lot this confusing mystery money into his very own greedy pockets. This governot is nothing but a problem waiting to happen.
“Similar findings about eligibility determinations have been noted in audits each year dating back to 2005.”
Guess they should have hired fifth graders 7 years ago.
Nope.
Not a peep!
Don’t I remember Joe Bruno’s name being connected with Goold Systems?
Again, all the hubbub could be solved by taking the data from the two systems and throw it into an Access database (a childs tool), slice it, dice it and get valid results.
That’d be one fancy MS Access DB!
You can save yourself the trouble and use MS Excel! Not even a workbook, just a single worksheet!
Even better, lol. Excel the prefered app of the bean-counter, what-a-mess.
Wow I thought computers didn’t make mistakes..I was told many times it was the person entering the info…the plot thickens
I don’t know how, after weeks of talking about this, people still don’t understand that this issue has nothing to do with what has been entered in System A and NOT fed over to System B. It is not that the work is done wrong, it is that the work that is done in one system has not been “fed” over to the other system. Why is this so hard to grasp, they only mention it in every article.
It sounds like Marden’s management style ain’t cutting it in Augusta !
Ahyup, quality is involved.
About time to clean house. Start fireing from the top down..
with a recall election.
“Similar findings about eligibility determinations have been noted in audits each year dating back to 2005.”
But..but..but. you mean this mess started in the second year of Badacci’s first term..but … but how then can I balme this on Mayhew and Lepage?
First of all , to the Lib’s running their yap’s on this matter I say this, Your Argument is Invalid, now move along. But more importantly, and disturbing, is that we now finf that after more than a month of this supposed” News paper” running “stories” and editorials about Mayhew withholding information, we now,just today, have these crack pot reporters finally ,and I bet it was a slip up, admit that this info that Mayhew withheld has been not only know for more than 7 years but it was a line in annual reports since 2005.Lib’s, time to move it along now.
How will you get by?
Just fine ,Jane,just fine
Yes they did and this is exactly why the Government shouldn’t be in the health care business.
And pray tell, who should be in the healthcare business?
and then Lauren said?
These people knew their Maincare had been terminated yet continued to use it. That is the same as stealing. Why are these 19,000+ people not being required to pay Maincare back???
Hey sheep! Read the article it states these computer problems date back before Gov. Lepage was elected. This is a result of the democrats having control for the past 30 years. The democrats created this cess pool of welfare dependant people. If the democrats were still in charge none of this would have been made public.
Dems did not cover anything up
RIGHT OK tell more inaccurate information. That is why the Baldy lost more than 200 million dollars and nothing was ever done to find that money. That is why Democrats such as Libby Mitchell, Hannah Pingree and Rino’s such as Anne Jordan under Baldacci used their offices to make profits and give special favors to companies if they helped fight referendums that benefits Mainers. Nothing was done about this unethical behavior. Democrats in Maine have been getting away with all kinds of fraud and illegal behavior but its ok for them to do what they want when they were in power and they blamed everbody but themselves for their mistakes.
This is not political you have state workers that did not do the job they were suppose to do… I called them a few years ago to let them know what was going on. I asked them if they do audits. no but this year ( 2012) we are. I could not understand how they can just give away money and not look to see who has it and where it was going..
No Computer Science major here ^^^
Nice! the reference to sheep priceless. My only comment would be that if in fact the news had leaked out in a D environment… the most likely response would be to raise fees ($100.00 to register a boat) or go tax the rich!
It would have been fixed in Jan.
And we would know how much money the State really has BEFORE the budget is written, too.
How about we clean up this mess and leave the attack politics for the election season.
Talk about zero referential integrity. LOL
Is there ANY chance that ANY funds expended by the “runaway” computer can be recovered by the taxpayers of the state?
I think it might be time to retire this computer and its over-payment features and get a new system. Maybe one that UNDERPAYS for a change!
Don;t forget that we nearly had a services crisis recently for the hundreds of service providers that were not getting paid, and as a result they were facing financial issues they should not have been forced into.
So.. the system DOES work both ways, and creates hardships for the providers of services as well.
This is the SECOND system that has been purchased within the past few years. The first system was the one that didn’t pay the providers. That system went online without ever letting the providers know ahead of time. This “new’ system, provided by Molina, was the other ones replacement! Nice, eh?
Sally,
Thanks for this. As I said in my post above, I suspected a procurement issue. Is the sytem you are referring to directly related to MaineCare Elgibility? Do you know when that system was put in place and who the contractor was?
Check this article: http://www.ihealthbeat.org/Articles/2005/4/6/Maine-Addresses-Medicaid-Billing-System-Problems.aspx?topic=Business%20and%20Finance
Sally thanks..that is the story on the provider payment system many have referred to here. ..all that 7 years ago..Is the Molina system you refer to the eventual outcome of that.. a replacement for the provider billing and reimbursement system?
So, seems possible that in correcting the billing ad reimbursement sude with the new system..they “forgot” to make the connection on the eligibility side so the two systems don’t reconcile continuing to show elgibility in the payment system which if correctly designed should have been driven by the most current updates to the eligibility system. But hard to believe any competent system designer couuld make such a gross error in design.
Steve Mistler did a nice piece on this earlyonn in the Sun Journal which has many useful links. He notes that the eligibility syetm error was known in the summer of 2010 and referenced then in an auditors report. So it is possible that in addition to whatever compatibility flaws there are between the eligibility and paymet systems, there must also be some ancient flaw in the elgibility side…that can point to either an innternal error in the system itself ( failing to trigger a notification of ieligibility to the recipient or failig to correctly update the record or move its contents to a refernce file ( fir use in furture audits).
Ultimately systems are oly as good as the humann resources behind them. If staff resources affecting input and quality control to the sytem were impaired, that would effect the system itself and it would contain incorrect information.
The audit Mistler referred to was not specifically of DHHS..that seems to be essential and the legsilature should order it by resolution.
Yes, Molina replaced the unworkable billing system that they put in in 2005. It was a nightmare for providers counting on reimbursement. Molina is better but still has its issues. I know that every state has their own rules, etc… but why is it like reinventing the wheel when software gets upgraded or replaced? There are 49 other states that we could get advice from.
That seems to confirm my point (way above) that it is a management problem.
And one that actually could be easily solved by humans beings actually taking control of
their computer systems and changing the account status, at the same time that they actually
(snail) mail out notices of those account changes.
Well it shouldn’t be..that was the point of my first post..there are ceratin very basic very well established best practices for integrating and cross checking eligibility . benefits and payments systems.
My management consulting practice in children and family services many moons ago (30+) involved a lot of systems evaluations as well as systems designs. In my opinion all systems designs for large public agencies require a very very thorough knowledge of the operations, of the people responsible for inputting data and how they connect to one another. IT expertise alone will get you a very poorly designed system and because the people procurig it are not IT themselves it is difficult for them to evaluate it.
That may be what happened here..way back when with the first systems and also with this belated redo of the payment system.
There are so man many simple quick and easy lo tech ways to reconcile indeenpdent systems and get a sense of what is wrong..eg checking a random sample of vendor claims pending payment to a simple search for those inn the elgibility system and then back to paper files..one person a few hours. So easy to write an algorithm to created a sorted listed of all unnique benficiary numbers in the payment system and compare that manually to a sorted list from the eligibility system..so simple to write a simple bridge algorithm that reads from the payment file back to the eligibility file.
But what’s at issue here is when LePage & Mayhew knew about the 19,000 inelgibles receiving payment, why they held that infomation back while advancing cuts for 14,000 eligible Maine Care people. The legislature and all legislative committese have a right to completely acurate and factual information from the Governor and from each of the agencies especially when it has a bearing on a requested legislative action. That is the heart of this. That is the wrongdoing at issue.
Agreed.
bingo
Just as a point of clarity, the systems that Sally is talking about, neither determine eligibility, they are both billing systems. The Eligibility system was installed in 2002.
Thanks PFFT2..yes I got that the two systems Sally referred to were about provider payments and billing and what you just added to the solution is that the eligibility system hasn’t chaanged since 2002. So doesn’t that mean tha tthe disconnect between the two systems had to have happeed with this latest update to the payment/billing system..or could it be that the human end of input to the eligibility system just got clobbered in the dismantling and reorganizing Le Page ordered?
Also why aren’t more DHHS people coming forward especially i a forum like this where their identity is protected ( or could be)?
It’s called ACES (Automated Client Eligiblity System).
Yes, I know that.
Based on your comments, I knew you knew that!!!! I’ve been gone from there for almost 5 years now and don’t miss it at all!!! Retired just in time!!
Retirement is ALWAYS just in time :)
An important point Jason..billing and payment constitute something like 35% of total health care costs and many providers were stretched to the point of breaking by long long delays in Maine Care Reimbursements that went on for years and years.
It looks to me as if it would be an awful task, trying to figure out the state funds and the fed funds that would need to be paid back. I agree a new system is needed.
You can thank the wonderful contractors that the State hires out to the lowest bidder, rather than finding quality workers that were born in the US.
I 100% agree with this. But when the lowest bid is $20Mil, it is hard to convince taxpayers that going with the company that is bidding $30Mil would be the better investment. Of course, in hindsight, that other bid might’ve been a better idea. Or not, you could just as easily had a similiar situation. Hard to tell.
You’re right – what is up with this? Not to support the computer, but with the business I am in, you see participants in Mainecare elligible one month, out for two, then they qualify again for 6 months, then there is the retro-paying back since they should have been covered the two months that it was cancelled…getting the picture here? It is, after all, a computer system – it is not going to be able to keep up with this. We can barely keep up with it.
Don’t throw rocks or rotten veggies, please, but maybe there needs to be a better way of qualifying people for the insurance, and unfortunately if they qualify, it’s valid for a set amount of time (like 6 months), not one month here and there. If you do not qualify, though, same rules apply, you can apply in X amount of months (six months). So you pay it here, but save it there. I don’t know, but the current system is a joke, especially to those of us who, yes, PAY for their health care.
I think you are so right. the current welfare system fails because rather than being a bridge to a better life, it’s more of a ceiling holding people down.
every time someone on welfare tries to better themselves, benefits are taken away and they end up at risk again. the situation you described above is unstable. extending benefits for a set period, regardless of income allows folks to recover from poverty.
Give LIEpage the same number of years and we’ll see who wins in the fraud-fest!!!
Good morning uncledrinky
Baldacci definetely! Dont forget he sold off the liquor stores to his buddy in Mass.
Can’t wait for LIEpage’s excuse for this one. Better take off that pretty scarf before you fall on your sword Ms. Mayhew.
LIEpage, clever. LePage actually broke into the DHHS office and hacked the computer system to create this problem, it hasn’t been reported yet, but you wait.
Was that from January to March of this year?
Stop the nonsense stop the lies, there was no computer error. The problem with these state workers they never did audits. IF you did audits you would of found this problem years ago. You had providers milking this system, cause they knew they could get away with it. Everyone was trying to make a buck off your accounting mess.
How long are you going to blame the previous administration?
The same amount of time your party keeps blaming Bush, I think that is fair.
Well Obama and Liberals continue to put the blame on Bush for all of his failures.
So true that is!
For as long as you keep complaining about the current one!
Until you Democrats take the responsibility you deserve
I guess one might think that if we can believe your base point, that already happened
when the evil of the “past forty years” was ended by your minority vote.
But the past year is YOURS, and yours alone, given your heroes control the State Government in Augusta, so where is your superior sense of responsibility, right now ?
Why are we not to think that you conservatives are no better that what you complain about,
which is my being VERY liberal towards your hypocritical silliness, isn’t it, Mr. Engineer ?
Thats the problem. You dont think. You just react. Its amazing you left wingers think everything is going great when your in control. Spend spend spend, thats OK. Its going to take more than one term to fix up the total screwups that were done under those previous
administrations under Democrat control. Silliness? You are so open minded that your brains all fell out. Probably didnt notice did you?
So how does an engineer think that can you cut taxes and balance the budget, honestly ?
It was it balanced last when ?
During the Clinton Administration, before the Bush tax cuts.
Are those the facts in your world, too, or not ?
If not, what are your faith based political operating myths, then ?
How well, have the tax cuts worked so far ?
What do you expect to be different, now ?
Doing the same thing over and over expecting different results is insane.
AND once you understand their stubborn position, people who will not or who can not
compromise have no place at the table. Look at Congress.
We have both heard the theories and seen the results.
Your insults are fine, though.
It is all you conservative have, now.
I know, because I’ve seen the record.
The record is what people will vote about.
But your insults and no compromise even handedness about it will help, too.
Keep up your great work.
I don’t believe that that many people aren’t suppose to be getting benifits. many people in this State need medical covarage. I think that it is actually the Sate’s fault for thier software actually not programed right.
If I programmed for the Medical Center the way the state does, I’d be fired. This isn’t the first time, the computer system is a joke. When was the last time that was audited? I’ll bet you will find a lot of people have done well in ME, these errors are beyond my comprehension and just prove how incompetent they are.
By they, I hope you mean the independent contractors that created the systems. No state worker actually built these horrible systems.
Then who accepted the horrible system? Who commissioned the system per the established specifications? Hmmm… how about an analogy. Got it! I contract with an organic farmer for a bushel of carrots. When ready, the farmer calls and I pick up the sealed container of carrots. I don’t open the lid to look in prior to paying and
leaving the farm. My wife is cooking rabbit stew the following week and asks me
why I bought purple carrots grown with Miracle Grow fertilizer. Purple carrots
I say! I wanted organically grown orange colored carrots?
If specifications and or performance requirements are not established early on… and verification procedures are not in place to ensure that the specs are met, then when things go to shite why is anyone surprised?
Buying the cheapest system is not always the best idea and usually the worst. However, the should have state workers that know how to run the system and to audit them. I was a techie in a med center, imagine us being that sloppy?
It is amazing to me that these kinds of problems could still exist. Building and evaluating medicaid eligibility quality control systems (and coordination of benefit systems to insure non duplication of payment) was part of my management consulting practice more than 30 years ago. The need for integrated systems for eligibiity and benfits programs of all kinds has been known for ever.
It is not an insurmountable challenge to design/build that way from the outset, or to fix when you know you have a problem. The story here, I suspect is around the procurement for the two systems which don’t talk to each other, and now the Governor’s unwillingness to innvest in correcting the systems for programs he wants to elminate. In other words, his ideolgy is more important to him than the millions this fixable error has cost the state.
I really think this is a matter where the legislature should direct by resolution an indepedent and immediate audit to determine when and how this systems conflict ocurred, what if any actions were taken to address it and what if any communications about were made to the governor’s Office and/or to federal officials. This is a $120,000,000 error, according to Mayhew. Mainer’s will have to pay the bulk of that. We deseve more than we have been given by way of explanation.
If Commissioner Mayhew knew about it from the outset of her appointment, it was existing and known ( unless she was on watch when one of the procurements was done for one of the incompatible systems). Why else would the Governor stand so heroically by Commissioner Mayhew when the $120,000,000 error became known? I wonder if the working papers bill was about this. Hasn’t anyone made a FOIA for all communications between the Governor’s Office and Mayhew’s on this issue?
Two wrongs do not make a right. Just saying the other guy was worse does not solve the problem.
exactly right. some commenters seem to want to ‘race to the bottom’. as if that helps our country.
It is all that poor dears know because instead of compromising and finding solutions, even when they control the Government.
They are programmed to hate the dang govermit, even the one that represents their “values” *.
Why should ever trust people like that to run one, ever again, then ?
* They even have even forgotten ( hate ???) that GW Bush WAS SO one of them, already.
It was my understanding that there was a new computer program implemented in 2010-2011 which was approved by the federal government unlike the previous computer program. Plus, I really don’t understand why the cards would still remain activated. There must be a way to put a hold on a card just in case the recipient ends up re-qualifying at a later date.
Ok, so. You have two systems. Eligibility System is where all “eligibility” criteria is. A worker can close a case in that system. It is then supposed to feed over to the billing system. Where the people who pay the bills are. Now, if that feed over does not happen, when a bill comes in the billing people see the case as open, and pay the bill. They do this, even if the case was properly closed in the eligibility system, because the correct and current info was not fed over to their system. They can not see the Eligibility system (and vice versa), so they see an open case and pay the claim. The card itself is a non-factor, you might not even need it if your Dr. knows you well enough. Its on file, the only important thing is the Mainecare number. So in essence the card is never “active” it is just a form of showing what the person’s Mainecare number is.
Why people still use their cards, can be numerous. Perhaps they didn’t get the letter. Perhaps they thought they would be billed and when Mainecare paid the bill, figured the letter they got was wrong.
Regardless, its a complete fiasco.
Also most doctor’s offices check the automated phone system to see if a patient is known, especially if they hadpreviously received MaineCare. The patient would not have even known that the doctor billed Mainecare.
Yes, indeed. People seem to have a very limited grasp on just how big a program Mainecare is, and how many tenticles it has.
Doctors want to get paid, they are going to bill and not care if the bill “should” have been paid by Mainecare.
Whatever suits the GOP at this time….but when the Democrats explain the mess that GW Bush and Cheney left Obama with, Oh that never happened! LOL
actually, the ‘libs’ did say something. they said ‘Go Eliot Cutler’
there has to be another Florida resident that could help us out, in our troubled times?
not sure if i get the reference. are you referring to rubio?
We need to find a smarter Floridian to run for Governor than the present Governor.
Poor Gov. Yelling at subordinates worked at Mardens.
I don’t think he is unintelligent, I just think he has reached his level of incompetency. (the peter principal).
Mayhew resigns in disgrace
But he didn’t cover it up like the current bozos
You want in on that bridge in Bucksport too?
I believe I first heard the title “Malfunction Junction” applied to Augusta about forty years ago . . .
I think this whole mess could be resolved if Paul and crew did a stint on Dancing With The Stars?Imagine the Gov. chasing his belly around the dance floor with Mary in tow. Make Maine proud.
It’s been 5 yrs since the State has brought in computers that should communicate with each other.
It doesn’t matter whether they are Democrates or Republicans …. the system hasn’t worked properly since day 1. I would like to know who built it? Who installed it? How much did the taxpayers pay for it? Is it under warranty? Now if it’s data entry issues ….. then that’s a whole different problem.
God Bless us …… when was the last time the State had a ‘Checks and Balance System” ???
Agreed… I would only add who Commissioned and Accepted the system as complete and functioning per the specifications!
I say go find the people, they knew they were no longer eligible, and PROSECUTE THEM or at the very least get hte money back
>>>>
That is such a ridiculous statement. The doctors got the money, not the patient!
Maybe Mayhew can get a job for a psychiatric hospital in MN.I hear they don’t vet evry well if you’re from ME.
Yep..and take Mainecare away from the people who are destitute in this God forsaken state..Mayhew needs to step and admit her mistakes instead of trying to cover them and tap dance around the fact that DHHS made a mistake. Always blame on someone else..She needs to step DOWN..She makes excuse after excuse..
Look at her trying to talk her way out of yet another mess.Why is the state responsible for computer errors?..Why do we have to pay back anything when all she’s done is cover it up? She’s making a fool of herself..She won’t take responsibility for anything at all. We as Mainers have to get up each morning and read these ridiculous newspaper articles about her..She needs to step down..Admit her faults..and hand it over to somebody who’s honest and actually cares about the people..All she does is make excuse after excuse..So unfair and unprofessional..I don’t know how she sleeps at night..
He wouldn’t lie about it though.
Yeah and I have abridge in Bucksport thats for sale if your interested?
Lepage needed to hide these loses so he could pay for the $17 million he illegally gave to his country men up at Brookfield Management of Toronto Canada.
I think it’s called IT; hire some.
Time for DHHS Commissioner Mary Mayhew to step down. Continuing to find “eligible” people for MaineCare benefits, and the lateness of notifying lawmakers of the first 19,000 should be enough to warrant her stepping down in favor of finding some one who is much more qualified to deal with the issues that continue to plague DHHS. Continuing to blame a previous administration is getting rather old, as is the way the LePage chooses to treat certain members of the Legislature. His latest outburst call Justin Alfond a “Spoiled Brat” is the latest in a long line unprofessionalism. What LePage fails to realize is that one would be hard pressed to find another family that has done more for the State of Maine than the Alfond Family. It may finally time to begin a recall election for LePage. Afterall, he did fail to gain a majority in the last election.
Sorry but I disagree. She was handed a mess and has been working to rectify this mess that was so nicely left to us by the Baldacci administration.
LOOK WHAT I FOUND! This is like Ronny Reagan and his band of outlaws all over again
There are no computer errors of this size that go on for years. There are people errors, they are asleep at the switch. No one was checking that the computer was doing it correct, because no one cared. Fire a few people that should have caught this and those that are left will actually be checking.
Let’s do the investigation, find this stuff out, and throw them in jail, where all thieves belong.
Conservative faith based political myths aside, who really is weak on crime ?
(Where at the all the arrests for all the voter fraud that the States leading LEO’s just knew is happening, like may-be because of how they run their caucus, for one example ? )
By the time LePage is finished with Mainecare there will be 10 eligible people left and they will probably all be relatives of his.
>>>>
I lol.
Well, well, well, more trouble in LePages’ fantasy land. This audit only covers thru the end of June 2011 if I understand this correctly. That leaves 6 months of 2011 and 3 months of 2012 to still be checked for accuracy? This seems like a he!! of a mess to straighten out.
We wre in this mess because of LePage and his un derlings knowing nothing about Government.
LOL… Who’s (whose ? ) on 1 st ??? What a debacle this buffoon has created, all the while blaming someone else.
And Mayhew is still employed??
It appears, from some of these posts, LePage is responsible for all the problems in Augusta. How convenient.
Send a bill to the people who got FREEBIES at *our* taxpayers’ expense. Use the damned Maine Revenue Service to collect it. They’ll pursue like there’s no tomorrow.
If the rabbit hadn’t stopped to take a dump the turtle wouldn’t have won the race. Nothing like getting off topic DC
Excellent comments and noting of the fact of the current mess. Maybe today Mary whowho will find #23 million tdhat she forgot to tell us about. This cannot be rea???
http://fu.gy/20Y
“The billing system undergoes regular fixes to address a long list of problems dating to its implementation in September 2010”
There were glitches before 2010 … before 2009…. even…. Time to take a good long look.
Fall out from Baldacci…
Not holding the vendor who designed the system responsible as Idaho has been trying to do; or the Obama administration, who certified this computer software as fully compatible with Medicaid’s eligibility criteria; is journalistic irresponsibility.
I bet when the BDN’s computer software doesn’t work, it’s not the operator’s fault, but the vendor!
The
client (State of Maine) contracts with company “A” to provide a
product or service that “shall” meet agreed to specifications. Prior
to taking ownership of that product or service from Company A, the Client
develops or agrees to a “Commissioning/Acceptance Plan” which is used
to determine if the product or service provided by Company A meets the agreed
to Specifications. Either the product or service is Accepted or it is not. If
accepted the Vendor has fulfilled its obligations… if the system is not accepted
by the Client then the vendor is liable.
Do the people who are mistakenly covered know they are not eligible? Were they ever notified? How would a person know if the mistake is on the State’s shoulders? Just a question. Really like to know the answer if someone can. Thanks.
Gut DHHS!
Cut by Half
WIC, LIHEAP, EBT and General Assistance. Stop with the “faux drama” of all the
need that is out there. Yes offer food to those who truly need it, but limit that
food to items that need to be prepared. We’ll see then how much need there is
when the EBT wastes can’t open a can of Pringles for dinner… The elderly folks
that are on a fixed income and who aren’t blowing their SS checks at Hollywood
Casino – yes help them with purchasing oil. Any man that wants to call himself
a man needs to stop and think. Am I a victim? Am I whiner looking for excuses to
why I am not providing for my family? Do I need the smokes or should I save a
few bucks and buy my kid a winter coat and some school supplies? Quit relying
on others to subsidy your wants. Quit crying for the camera… Quit being a weak
minded drama queen and accept responsibility for your life. And to the media… Coats
for Kids etc. Kudos to you for what you do but call these campaigns by what
they really are: Kids who need coats… because their selfish deadbeat parents
put their own wants and needs ahead of their kids. I’m not for one second
buying the fact that a parent can’t come up with 25 dollars to buy their kid a winter
coat… they just choose not to.
Someone hasn’t been paying attention. Because if you had been, you would’ve noticed that Federal money comes with strings. Lots of them. Just look at all the things that LePage has not been able to do, because it would be illegal to do so. What you may want, and what is legal to do, may never have a merge-point. As for EBT, I assume you mean Food Sup, just so we are clear, Food Sup is 100% Federally funded, which means that LePage has very, very little oversight or control over it.
If you want to see changes to food sup, pray for a Paul Ryan VP on Romney’s ticket, then pray they win. Then sit back and watch the US, hit rock bottom.
I’m praying for either a gutting of existing Federal & State expeditures… or a total collapse of DHHS. In the event of a collapse…reasonable people from all sides of the political spectrum will come together and create programs that work for the truly needy of this State.
>>>>>
If “reasonable” people form all sides were capable of doing what you said, we wouldn’t need any social programs. Which should tell you, why we need them.
>>>>>
Awwwh you silly goose! Well I see that you hit all the Lib talking points. Let’s see: The elderly right… we want to push you off the cliff, yes children – do you have no heart! Nazi? had to get that one in there. Short of a disability or seriousness illness, how can any man feel any self worth or pride if he has an EBT card in his back pocket, or has to go crying for LIHEAP assistance?
>>>>>
You are a very insensitive person. I sure hope life never b-slaps you and you need to go “crying” to LIHEAP to live. It gets damn cold here in Maine, be careful how callous you are toward fellow citizens of this state, karma has a way to even playing fields.
The first time someone you love can’t afford to eat or heat their homes, I suggest you let them starve and freeze.
OMG has the state ever heard of interfaces. This allows one software to talk to another- A reliable company is called Iatrics- look them up! Funny how the found 14.3 million dollars yesterday and we can’t have a small respite, because Mary and he minions can’t get their act together. I do not blame Republicans or Democrats as a separate entities, I blame all of them and the independents, etc. Time to clean out the trash in Augusta and hire people who know what they are doing it and whom is doing it.
It’s too bad this issue is being politicized. Let’s get some talent and fix it.
God bless Mary Mayhew and her team, as they sort through this never-ending mess. If you’re a praying person, please send them one. If you’re not, please wish them well.
Really?
Pathetic.
Money missing. Money found. Simon says “Get it together” or pay the price at the polls. Is there anyone honest person out there? Or is government doomed to greed and narcissistic bottom feeders? Can’t wait to see the next run of promising everything when campaigning and then delivering nothing but the same old same old. One can dream of a time gone by when everything seemed fair and obtainable. Now life has become to say the least hard and month to month heading for day to day.
“One of those fixes finally closed the 19,000 cases in early January, Mayhew said.“That fix was only able to close the cases retrospectively,” she said. “As we continued to receive feeds from the eligibility system, that same core issue still existed.”( like your accounting computer did it regular scheduled cleaning, and purged clearly inactive accounts)
“Beginning in September 2010, some MaineCare recipients were sent letters notifying them that they had lost eligibility but MaineCare cards remained active for those ineligible recipients.”
(but no one updated the ( “sales department’s” ) customer data base,
which, naturally as SOP, is separate from the active accounting program …)
May-be this is just a business management failure, Ms. Mayhew.
Given that business system computers are designed for business, perhaps you need to run your Dept. like one.
It is only natural that when a particular account changes its status,
such that the operation MUST communicate by letter to inform their clients of that change,
that a computer system WOULD NOT close an such account, nor delete past customer account information without any active management input.
It is only natural that a well run business would manage all customer account information,
even inactive account information, separately from “accounts receivable”, for planning and better customer service purposes, at the very least. For example if a customer reaches his credit limit, who would want the computer automatically closing that account ?
That SOMETIMES means that they are a growing business and not only still a good customer, but a great one.
A real business solution would be that if you send a letter that you are closing one of your client’s accounts, have a authorized responsible human being actually close that account, or at very very least flag it for closure on such and such a date, THEN post the letter.
Problem solved ?
It is only a big deal because of poor management since
“One of those fixes finally closed the 19,000 cases in early January”, Mayhew said.
Besides, YOUR buffoon IS Governor, now, and Ms. Mayhew is his gal.
That makes absolutely no sense.
I feel like I’m at the dog track in Florida with these DHS accountants. Someone is going to win, but it’s not me or my family.
How does someone become INeligible for MaineCare – by increasing their income?
That’s one way. They could also lose dependents which may make them over income.
Yes, or they could inherit money and then become over assets. But if it is income they usually get 6mos to a year of transitional Mainecare.
I bet big Paul will throw little
Mary Mayhew under the bus on this one.
I don’t think so, if he was going to, I think it would have already happened.
He is probably waiting for her resignation to land on his desk, then he will throw her under the bus.
You know, if this were any other department, I would tend to agree with you, he has definitely accepted a lot of resignations. This time, I think she is not going anywhere.
Couple of reasons, first, he has already publicly stated he fully supports her. Second he had to drag the bottom of the list of names before she was offered the job. I don’t think there is anyone out there that would take this huge cluster, in mid-stream.
This computer problem started during the Baldacci administration. While they didn’t fix the computer problem, which they should have done, they were aware of it and somehow compensated for it so people that shouldn’t get money, didn’t.
When the LePage administration took over most of the people that did the daily work of running DHHS stayed on and would have known about the computer problem and how to get around it. Presumably they told the LePage administrators so they too would know there was a problem but also the solution.
OK so what happened? How come all of a sudden there are 19,000 and then 5,000 too many people getting checks. Did the LePage administration not listen?
I love how they throw that word “Mistake” around like they are passing a piece of candy. I can guarantee you with 100% certianty that if we owed them 1 dime for anything there would have been no mistakes made sending out the bill. The computers would have worked fine and seem to have worked fine all this time except for when the state gets caught not doing their job….again. Pathetic.
I grew up in a Maine which had no DHHS and we got by fine.