Tuesday, April 12, 2016

NC DHHS Secretary calls Medicaid Providers "bad actors": Fine Start to the 2016 Legislative 'Season'

Marsha V. Hammond, PhD  Licensed Psychologist NC #2748
email: chomskysright@gmail.com    cell: 

RE: Medicaid committee legislative meeting today at 1 pm

Dear Medicaid Committee Chairs, Dollar, Lambeth, & Hise: 

I have been a Medicaid proivider for over 10 years.  I have been in practice over 20 years.  My Medicaid clients are the sickest clients I have  I don't even BILL Medicaid for my dually eligible clients who have both Medicaid and Medicaid.  Its too much trouble.  When the LME's took over the management of Behavioral Health, the automatic link between Medicare and Medicaid was severed.  That was years ago.  Moreover, if I get my Remittances from Medicare and then turn them in to Medicaid, I have to pay my biller a second time.  Then I have to endure the LME going over my records with a completely unnecessary fine-tooth comb that bears no relevance to me seeing my suicidal client in their home at 10 pmat night.  

I noticed you were all in a hurry to make your 5 pm deadline today.  I have no 5 pm deadline.  I am available 24/7.  Don't believe me? Ask my clients.  Do I feel appreciated? Not at all.  I heard the Secretary call us possibly "Bad Actors" or "providers who needed a little extra assistance.  

How about NC Tracks do something sensible like having the Recipient portal communicate automatically with the Provider portal.  Because this does not take place  I HAVE TO CALL THE PROVIDER PORTAL TO LET THEM KNOW THAT MY INFO HAS BEEN PLACED IN THE RECIPIENT PORTAL my recreditation is in no-man's land, with my claims not being paid  That is just the beginning.    I feel harassed and AM harassed by SMC LME which in December 2015 gave me 24 hours to answer an e mail or my recredentialing was dismantled.  

I wish I could say I was bemused by the audio recording of the Medicaid committee meeting today.  I was horrified. I have been corresponding with Rep Avila re: my concerns re: SMC LME/MCO, and NC Tracks.  I am attaching letters from the dysfunctional NC Tracks system.  Please pass these docs and comments to anyone you like. 

These are my concerns after listening for merely a few minutes: 

1. NC Tracks DOES NOT WORK   We were much better off when Value Options was managing Medicaid and before the LME's began wolfing down all the Medicaid $$ and harassing we, the providers, over tiny pieces of paperwork that has no clinical relevance.  

2. The matter of "fraud" was laughable.  One of you asked about underpayments.  You got no answer that I heard.  As I said, I don't even bill Medicaid for thousands of dollars each year because of the expense related to the severing of Medicare and Medicaid and because SMC LME requires things like my session notes match my Treatment Plan when my client has become suicidal.  I've never seen such a mess.  As far as I am concerned I am being defrauded rather than the opposite. 

 I do my job and I do it well and SMC LME plays cat and mouse.  I have asked for a release of my records under Public Records Law Chapter 132 because otherwise they would not release the internal emails related to their harassing of me.  Why do they harass me?  I have managed a blog for the past 8 years describing all the problems with Mental Health in NC.  Does this make me popular with the LME's? Well, Western Highlands collapsed due to mismanagement but their employees floated over to SMC LME and they remember me VERY well. 

I am requesting that I be allowed to speak in person to this committee  I don't like driving from Asheville to Raleigh but really, all you heard was what the Secretary wanted you to hear.  I am not alone.  A Meridian Behavioral Health Services recently told me: "Trying to work with Smoky is like being harassed by a debt collector."  

You consider how that might affect your ability to provide efficient, high quality mental health services.  I am looking forward to you giving me a date when I might speak in person.  

Marsha V. Hammond, PhD


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