As of Thursday, the state Health Department had issued $5.2 million in safety-net payments to early intervention providers that haven’t received the majority of the money they are owed since the billing and payment system was revamped in April, Jeffrey Hammond, a spokesman for the agency, said yesterday.
A total of 247 providers of services to children under 3 with special needs had expressed an interest in receiving payments since the Health Department made the announcement Aug. 13. Of those, 106 had returned the required agreement, Hammond said. The Health Department issues payments on a daily basis, with a turnaround time of 24 to 48 hours after receiving the paperwork, he said.
Counties used to pay the entire cost of early intervention for infants and toddlers with special needs before billing Medicaid and private insurance companies for services, which include occupational therapy, audiology, nursing and other types of care. On April 1, the state switched to a new system that gave the responsibility for billing to health-care providers, which have to bill through the state’s new fiscal agent and receive an insurance claim reimbursement or denial before getting paid by the state or county.
Providers have said they are experiencing financial hardship because of all the paperwork and delays involved with the new system. Some have closed their doors, placing services for needy children in jeopardy. Early intervention for infants and toddlers is often critical in helping children eventually overcome delays.
The Health Department originally asked counties to front payments to local service providers, but it elected to make safety-net payments on its own after receiving few takers. Putnam was among the handful of counties that agreed to help providers financially. Under the state’s offer, providers are eligible for 75 percent of claims to insurers through July 29 for which no payment or denial has been received. The Health Department can send out up to $13 million.
The Health Department has blamed insurance companies for the problem, saying they have not complied with the new system.
Assemblyman Tom Abinanti, D-Mount Pleasant, has said the state “broke” a system that was working and said the “avalanche of paper requirements and red tape that they created” has caused a logjam in the system.
The $700 million-a-year early intervention program serves about 75,000 children up to 3. Unreimbursed costs after private insurance and Medicaid are paid by counties (51 percent) and the state (49 percent).