Wednesday, July 18, 2012

Medicaid Waiver: All the Little Ways that Piedmont Behavioral Health Has Benefited from the Medicaid Waiver

Well, I just finished 2.5 hours of non paid training in order to bill for my Medicaid clients under SMC LME. Prior to this,before the Medicaid Waiver, I simply went to 'webclaims nc medicaid' and it took me 5 minutes / client for multiple outpatient therapy sessions to bill.

Now, I have to fill in boxes of information which is associated with a piece of Software, Alpha CMS, which was created by a 'spin off ' group (I am quoting Robert Webb, the IT guy at SMC LME who led most of this computer webinar training this afternoon) from Piedmont Behavioral Health, the LME who started the Medicaid Waiver in 2005. 

PBH are/ were using, Mr. Webb stated, the 'Cardinal' system and (undoubtedly) the smarter ones or less unethical ones, seeing the opportunity to peddle their software to the LME's, sold it and developed it to SMC LME and other LME's in eastern NC.

Of course, only half of the LME's in NC wanted Alpha CMS which is utilized to do all of the authorizations and billing associated with Medicaid and state funded clients. The other half of the LME's, including WHN LME, use another kind of software.

I'll make a wager: the other half of the smart people who 'spun out' of Piedmont Behavioral Health created the other software that the other LME's are using.

Since the Medicaid Waiver is funded by the feds and state tax dollars, how is it that people who were employed by Piedmont Behavioral Health were able to use what they learned while developing the software for PBH and go out and create a fortune by privatizing their publicly funded knowledge?

My, that's a strategy that Mitt Romney would applaude.


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