Medicaid Backlog May Have Financial Ramifications

Docs might have to wait longer for Medicaid reimbursement, may incur costs for those denied cover

TUESDAY, June 24, 2014 (HealthDay News) -- There is a considerable backlog in Medicaid enrollment applications, which may have financial ramifications on physicians and practices, according to an article published online June 10 in Medical Economics.

The author of the article, Donna Marbury, reports that the applications of nearly half of the six million new patients that have enrolled for Medicaid coverage have yet to be processed. Consequently, physicians may have to wait even longer for Medicaid reimbursements for patients who have not yet received authorization. Furthermore, there may be costs incurred by practices for patients that signed up but were denied Medicaid coverage.

An estimated 2.9 million Medicaid applications have yet to be processed, including more than 900,000 in California, according to Marbury. Technological glitches account for some of the delay, together with a high volume of enrollees. Many states have encouraged people to enroll in person due to difficulties with online applications.

"It is a concern. The purpose and intent of Medicaid expansion and the Affordable Care Act was to create access and remove barriers," said Robert L. Wergin, M.D., president-elect of the American Academy of Family Physicians, according to the article. "We encourage our members to see patients as they need care, but the business model is set up to pay practitioners less than their overhead."

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