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Medicaid program under fire


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POSTED: Friday, February 27, 2009

Health-care services have been disrupted for some of Hawaii's 39,000 aged, blind and disabled Medicaid recipients under the state's new controversial managed-care program.

The program has had its share of problems since it began Feb. 1 under affiliates of UnitedHealth Group Inc. of Minneapolis and Tampa, Fla.-based WellCare Health Plans Inc., including computer glitches with pharmacies that resulted in co-pay charges covered under insurance, disruption in the transportation system used by patients, and lengthy wait times and busy signals at health plan call centers.

The state and health plans have received 34,750 calls from clients and providers over the past three weeks due to enrollment issues, health plan changes, pharmacy issues, questions about physicians, service coordination and transportation, according to Patti Bazin, state Department of Human Services health care services branch administrator.

“;We're trying to minimize the disruption,”; she said. “;I would be negligent if I did say that no one has been disrupted with this.”;

Thousands of Medicaid recipients still have not been assigned a primary-care physician under the new health plans, while others have been turned away from their longtime doctors who have chosen not to participate in the program, according to Arleen Jouxson-Meyers, president of the Hawaii Coalition for Health.

“;DHS has created an astronomical problem beyond belief by rational thinking people,”; Jouxson-Meyers said in a letter written earlier this month to Bazin. “;Patients will be harmed and some could even die as a result.”;

The program has come under fire by patients' advocacy groups opposed to the award of a $1.5 billion Medicaid contract to the two for-profit mainland firms, whose parent companies have been accused of fraud on the mainland. The state previously ran a fee-for-service Medicaid program.

“;Their parent companies do not have a good reputation,”; said the Rev. Bob Nakata, president of Faith Action for Community Equity, at a legislative briefing yesterday. “;There are suits in 37 states, federal investigations going on - this is what these people are up against.”;

The U.S. Centers for Medicare & Medicaid Services recently stopped WellCare from marketing and enrolling new members in its Medicare plan and prescription drug program nationwide. The ban doesn't affect its currently enrolled members or Medicaid recipients.