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A few getting paid after insurance crisis, many others not

CINCINNATI (Jeff Hirsh) -- Paychecks were finally starting to flow to some home health care workers who have not received a nickel since June 1, even though they've been on the job.. 
Local 12 began investigating the crisis July 22.  July 29, the worker Local 12 first profiled received a check but the troubled system is far from fixed and a lot of people are still scared and without pay.  Billy Lauterwasser has been helping Janet Mason the past three and a half years as a home health care aide.  But Billy may have to quit soon to look for another job.

"I haven't been paid since June 1. It's very stressful," he said.

Like many independent health care aides around Ohio, Billy is caught in a system which is not working.  The state of Ohio's switch from paying the aides directly to having insurance companies take over the program and the payments has not gone smoothly.  The checks have not been coming, in Billy's case totaling around $4,000 owed.

"I've been having to borrow money from my parents weekly.  It's been almost two months now.  I can't hold out much longer and I can't keep asking my parents for money," Billy said.

Patient Janet Mason said, "They're gonna quit and get other jobs because they have no income.  They don't know when they're going to be paid or if they're going to be paid."

Janet has another big worry besides losing her home health care aides.  Local 12 has reported that one health supply company is refusing to deliver products until they get paid by the insurance carriers.  And if that spreads?

"I'm afraid what's going to happen if they don't send them anymore.  My oxygen, if they're not getting paid, I need my oxygen. I'm on it 24/7," Janet explained.

That oxygen is still flowing for now, but there are still plenty of people and businesses in limbo.  Patients are worried about the future of their health care.  Providers are worried about their futures too, under a program which has gotten off to a terrible start.

The health care nurse Local 12 first profiled, Tammy Taulbee, told Local 12 Tuesday she is, "Beyond happy right now," because she finally received the $5,000 she was owed from Aetna insurance.  Taulbee works for a couple in Butler County taking care of their 51-year-old daughter who has been brain damaged since birth.  
Like many other aides, Taulbee had not been paid since June 1 and was afraid she would have to quit and find another job.  Since running Taulbee's story, Local 12 News has been inundated with calls from other providers and agencies who have not been paid either.  
Local 12 passed Taulbee's name along to Aetna and are doing so with other providers and agencies as well.  The state Medicaid department has also asked Local 12 for names of those who have not been paid yet, and Local 12 is working to pass those along as well, only with permission of the providers, of course.

The payment crisis began in the tri-state area June 1 after the state had insurance companies took over payments for around $100,000 patients eligible for Medicaid and Medicare.
Local 12 first reported how independent providers were impacted then showed how health care agencies, suppliers, and some nursing homes were not being paid either.  Aetna insurance has admitted problems within their systems and is now speeding up processing and running payment checks twice a week instead of once.
The company says it is also offering cash advances to some providers who are facing financial difficulties.

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