Computer problems that delayed payments to home health care and personal care attendant (PCA) agencies have caused frustrations and prompted calls for change. It also caused worries for thousands of service providers who wondered if they could even make payroll.
The Minnesota Department of Human Services (DHS) has worked since mid-September to fix problems with its MN-ITS service. MN-ITS is used by Minnesota Health Care Programs service providers to handle billing and to process background checks for new workers. State officials said they are working to make sure the claims and background information are processed promptly and properly.
Quality Living Home Health Care of Winona and Care Planners of St. Paul were two of the affected agencies. Quality Living owner Gary Poblocki told KSTP-TV that he spent days trying to access the state’s computers and file the required claims. Poblocki said he had not had a problem with the system in the 10 years he has owned his home health care business.
Care Planners also had problems filing its claims and was another agency featured by KSTP-TV. “Yesterday they put a recording on that there was a problem and then it hung up on you. I was like ‘Are you serious?’” said Christopher Hansen with Care Planners.
About 52,000 health care providers use MN-ITS. Because of the different timing of billing cycles, it’s not clear how many agencies were affected. The billing system is especially critical from a financial standpoint, because agencies that file receipts are then reimbursed with Medicaid dollars.
The problem grew so widespread, self-advocate Lance Hegland worked through Minnesota Consortium for Citizens with Disabilities to post an online survey and gather information. The survey ended October 9. Hegland plans to present his findings to the consortium and the Minnesota Home Care Association.
By the end of September Hegland had received 27 responses. Of those responding, almost all provider organizations experienced difficulty processing billing for services delivered because the MN-ITS service had been unavailable at some point between September 15-21. Nearly 62% of respondents indicated the service was unavailable more than half of the time. Although only a small handful indicated challenges processing background studies, a few providers indicated challenges with other critical activities through MN-ITS related to service delivery, including obtaining service agreements for new clients, getting individual PCA identification numbers for new PCAs, and receiving important time-sensitive responses from DHS regarding eligibility, billing, and other administrative inquiries.
Between 15 to 20% of respondents believe the health and safety of their clients may be at risk due to the outage. One respondent indicated he was experiencing challenges staffing client needs in a timely manner because of the outage. More than half of the respondents were concerned that they may have financial challenges if they are unable to submit and process all their billing and receive the scheduled reimbursement payment for services delivered before they are required to process their upcoming payroll. Almost 25% of respondents feared that their business may be at some risk of closing because of potential financial challenges created by the outage.
More than half of respondents felt that DHS should at least distribute a short memorandum summarizing the cause of the outage in addition to strategies they will use to prevent similar challenges and risks to Minnesota’s long-term care delivery system in the future. Roughly 25% of respondents felt that DHS should invest in a more extensive investigation and subsequent report to the community due to the significant challenges and risks created for our communities.
Two-thirds of respondents indicated they would consider endorsing community efforts to request a response from DHS.
