Texas: Medicaid system glitches cause headaches

AUSTIN, Texas – Texas providers have been finding themselves at risk of getting disenrolled from the state Medicaid program dues to glitches in a new technology system, says Adrienne Trigg, chair of the legislative committee for TexMEP.  

The glitches in the system, compounded by a guide manual that wasn’t updated, made it difficult, if not impossible, for providers to update their information. 

“It’s just a bond,” she said. “You’re not having to renew your Medicaid attestation. With Medicare, it’s easy – just give them the new date it’s extended to and the name of the bond holder, and it’s updated.”  

Trigg first learned of the problem from the compliance officer at Apple Homecare Medical Supply, where she is government & payer relationship manager.  

Even when a provider got through the process, there was no guarantee, says Laurie Bachorek, COO of Grand Prairie-based MetroCare Home Medical Equipment. 

“They began disenrolling providers, even though you put in your revaluation paperwork,” she said. “They don’t have time to process it on their end, so they are cutting people off receiving payments.” 

After reaching out to various department heads at the state level, to no avail, Trigg finally called on a former congressman for help. 

“That finally got their attention,” she said. “We finally had meetings with the department heads. We got 

them to promise they would extend our revalidation timeframe for 90 days, plus 90 more days would be limited to those who had already started their application.” 

Moving forward, state officials have promised to hold a town hall meeting to help guide providers through the process and have developed educational YouTube video, says Trigg. 

“We’re so grateful and hopeful that no other provider will have to be disenrolled for such glitches in the system,” she said.