Glitch threatens services for poor kids 03/28/2001

Associated Press

AUSTIN - A processing glitch has delayed state payments to some providers of health care and social services for poor children, causing some of those providers to warn Tuesday that they could go out of business if they aren't paid quickly.

The state's main Medicaid contractor, which processed the claims, discovered the coding problem and was working quickly to correct it Tuesday night, said Ken Smalling, a spokesman for National Heritage Insurance Co.

"It will be fixed tonight," Mr. Smalling said.

The payment delay had caused some providers in the Medicaid Case Management program who haven't been paid recently to say they were on the brink of shutting down. That would leave thousands of needy children without services.

The program is part of Texas Health Steps, a component of the state's Medicaid program. Texas Health Steps is the program at the center of a federal court case against the state.

The Texas Department of Health was also investigating the payment problem Tuesday night, spokesman Doug McBride said.

"It appears right now it's a processing error that could be easily corrected," Mr. McBride said. "If they're due payment, they'll get paid as soon as we can get this fixed."

About 50 providers across the state were not paid about $50,000 in claims, Mr. McBride said.

"The providers who should have been paid but weren't will be notified tomorrow, and payments will be issued no later than Monday or Tuesday of next week," he said.

Soon may be too late, the providers said.

"The frustrating part is we just don't know what is happening," said Carol Tillman of the Texas Association of Medical Case Management Providers.

Providers in the program depend on the weekly payments to stay afloat, said Scott Hensley of Texas Health Partners. The glitch has delayed $16,374 the state owes him, he said.

http://www.dallasnews.com/texas_southwest/323225_medicaid_28tex.html

-- Doris (nocents@bellsouth.net), March 29, 2001