Ohio's Medicaid system has been having IT issues for the past year, and the problem has been impacting the agency's ability to pay provider claims.
At a meeting this week of the state's Doula Advisory Group, doulas asked why they haven't been getting paid for their claims to Ohio Medicaid. Doulas certified by the state became eligible to bill Medicaid up to $1,200 per pregnancy after a change in law in October.
"We're having so many, aside from doula, claim-payment issues, because of our IT systems," said Alison Barr, an Ohio Medicaid program manager.
Barr told the group claims are being automatically rejected, and it's impacting the entire state, not just doulas.
"Hospitals have been severely impacted by this, so they've been my primary priority the last year probably," she said.
The claims can be paid, Barr said, but they have to be processed manually, and people have to come to her after a rejection to fix the issue.
"This issue...this is up to the governor who knows about this. This is way above my pay grade," Barr said.
Some healthcare providers may not know their claim could've been rejected in error.
WOSU has reached out to Gov. Mike DeWine's office to ask when did the problems start, what is the causing the issues and what efforts have been made to correct the issue.
WOSU has also asked how much money in claims have been erroneously rejected and why hasn't the public been notified.
So far, there has been no response from Gov. DeWine's office.
Barr said she doesn't know when a fix is coming. "This is really up to the legislature's priorities," Barr said at the Wednesday meeting.
Barr also said that when the system is working properly, the claims are typically handled almost instantly. Claims can only be paid if they're made within a year of the provided service.
