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State legislators ‘feel the pain’ over your Medicaid issues
e-Reports, Dec. 19, 2011
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One spokesman said it all for medical staff members attending the Nov. 11 ISMA Medicaid Coalition meeting. “We want you to feel the pain and frustration we have with Medicaid,” the practice staffer said.

The five legislators in the audience listened as attendees told the Medicaid managed care entities about issues that routinely cause problems and delays for medical practices.

First meeting pic Second meeting pic Third meeting pic
LEFT: Sen. Jean Leising, R-Oldenburg, and Rep. Donald Lehe, R-Brookston
CENTER: Rep. Tim Brown, M.D., R-Crawfordsville, and Rep. William Crawford, D-Indianapolis
RIGHT: Sen. Jean Breaux, D-Indianapolis
Not pictured: Sen. Brandt Hershman, R-Buck Creek

“We need continuity with the managed care entities. Let’s make the rules standard,” said one. “When we ask questions, you quote the manual and that does not help us,” said another. “We have read the manual and we need your help understanding it.”

Credentialing became a topic because it often takes an excessively long time. Provider representatives also were discussed, with one attendee complaining reps visit only physicians, not laboratories. Another asked if representatives have an obligation to visit because in two years as a Medicaid provider, the practice had never been visited by a provider representative.

Following a discussion of denied claims and delayed reimbursement, Sen. Jean Leising, R-Oldenburg, asked, “Who keeps the money when claims are not paid?” After what she heard at the meeting, Sen. Leising stated she worries who will see Medicaid patients, especially in rural areas like hers, if the program expands as expected.

The ISMA will convene a group of key stakeholders to work on the array of issues presented. For more details about the meeting, see the Dec. 19 Medicare/Medicaid Coalition Report.

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