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Independent health care providers gone unpaid for two months

CINCINNATI (Jeff Hirsh) -- The problem of home health care aides not getting paid in Ohio began after the Ohio Medicaid program stopped paying providers directly.

Insurance companies took over but the providers said they have not been paid since June 1.  They said they may have to quit to get other jobs and their patients will suffer.  The state of Ohio finally conceded something was wrong.  A memo from the Medicaid department said they heard of certain billing issues experienced by independent providers.  But Local 12 learned the issue went beyond independents who work for themselves.

The Ohio Council for Home and Hospice Care represents 500 agencies which employ home health care workers.  In a letter to a state legislator, the council outlined all sorts of problems.  It said it was clear the MCO's (that's the insurance companies) knew about the roll out months in advance and were not prepared for such a major shift in how Medicaid services were handled in Ohio.
The council said many agencies were struggling due to cash flow problems from not being paid.  One Cleveland agency had $300,000 in outstanding claims and was forced to lay off 10 people.
A representative for the Home Care and Hospice Association said he hoped to have a meeting in southwest Ohio within the next two weeks to deal with the problem. The change from state payments to insurance companies was part of a nationwide pilot program involving 15 states.  In Ohio, different companies handle the claims in different parts of the state.  In the tri-state area, it's Aetna and Molina.  Most of the complaints Local 12 received involved Aetna.
A spokesman for Aetna told Local 12 they were trying to deal with the issue saying, "We have identified the problem with our systems and are implementing processes to resolve this as quickly as we can.  In the meantime, we are manually processing claims, increasing our check runs to twice a week and;  where required, offering cash advances to health providers."

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