Happy New Year, everyone!!! Hope your New Year’s celebrations were safe and surrounded by friends and family! According to a journalist, the new year did not ring in the Medicaid reimbursements owed by NCTracks.  (Obviously I cannot comment on NCTracks’ current status due to the lawsuit we filed on behalf of all physicians in NC).

Here is the following article by Mike Voorheis…

A year after a Wilmington doctor filed a lawsuit, the state still owes his practice more than $100,000 in unpaid or underpaid Medicaid and Medicare services, he says.

Dr. S. Albert Abrons, a family physician, is the first of seven plaintiffs listed in Abrons vs. N.C. Department of Health and Human Services, a class-action suit, (filed by Williams Mullen), that seeks unspecified damages from the state and three other defendants responsible for the development and implementation of NC Tracks, the software that disburses Medicare and Medicaid payments to health care providers.

Problems with the software began immediately in January 2013 and continued for about 14 months, Abrons said. During that time, Abrons and his staff treated thousands of Medicaid patients. Instead of being reimbursed at the higher Medicare rate for primary care services – a provision of the Affordable Care Act – Abrons was reimbursed at the lower Medicaid rate.

That amounted to about $20 per visit, his office manager said, eventually leading to a six-figure deficit.

Abrons said that meant he had to take out loans and couldn’t give raises to his employees when he wanted to.

“The state still owes me and every provider, I presume, enhanced payments for 2013,” Abrons said.

Abrons fought the state to correct numerous errors beyond the reimbursement rates, he said. The harder he pushed, the less receptive DHHS became.

“There was a complete lack of courtesy,” Abrons said. “Those people have no humanity.”

N.C. Rep. Susi Hamilton, D-New Hanover, was also very critical of DHHS’ response.

“The problem clearly starts at the top,” Hamilton said, referring to DHHS Secretary Aldona Wos.

“There is an unwillingness to admit that there are problems. We’ve left several messages and were unable to get a response.”

The state filed a motion to dismiss the lawsuit in July and did not wish to comment further, spokesman Kevin Howell said.

Some organizations have had success in receiving their backlogged reimbursements. Wilmington Health CEO Jeff James said the state does not have extraordinary unpaid bills with his organization.

Elderhaus PACE’s Rick Richards said the state owes the Wilmington organization about $350,000. A plan is in place, he said, to have the debt cleared in the next 90 days.

The lawsuit argues that more than 70,000 providers in North Carolina may have had a claim against the state.

“It’s systemic,” Hamilton said. “It’s not about one physician’s profit margin or bottom line. The more we delay payment for services, the more reluctant the private sector is to provide services to Medicaid or Medicare patients. That’s not acceptable.”

Hamilton said that after 14 months of frustration that she’s grown more optimistic over the past 10 days, since speaker-elect Tim Moore has added his voice to the cause.

But even if Abrons recoups the money that is owed him, Hamilton said, his practice has still been a victim of the state’s mismanagement. Every paper that is resubmitted and every phone call that is made to the state costs money. And that doesn’t include the time and money invested in the lawsuit.

“Time is money,” Hamilton said. “They have experienced a tremendous loss even if they are reimbursed at 100 percent.”