State’s Medicaid contract gains in value

Published 9:54 am Wednesday, January 9, 2013

BATON ROUGE (AP) — A $185 million multiyear contract with a company to take over the state’s Medicaid claims processing is getting more lucrative.

State Department of Health and Hospitals Undersecretary Jerry Phillips tells The Advocate (http://bit.ly/VeW2lX ) Tuesday that an amendment will add about $8 million to the money CNSI will receive under its contract.

CNSI won the state contract, overcoming protests from unsuccessful bidders who claimed the business information processing firm had “low balled” costs. Skeptical Louisiana legislators in 2011 said they would monitor the contract for any amendments that increased expenses.

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DHH Secretary Bruce Greenstein had once worked for CNSI. He repeatedly has denied having anything to do with CNSI’s selection by DHH.

The change increasing the contract by $8 million is pending approval by the governor’s Office of State Purchasing.

CNSI, of Gaithersburg, Md., will take over processing the Louisiana Medicaid claims at the end of 2014.

The current vendor, Molina Medicaid Solutions, of Long Beach, Calif., had been scheduled to do some work, which cost $8 million. Because the federal government delayed the deadlines, the state decided to reassign that work to CNSI, Phillips said. No additional appropriation will have to be made to cover the cost, he said.

Phillips said the contract alteration was prompted by a U.S. Department of Health and Human Services decision to delay a revamp in the international classification of diseases codes.

Instead of about 20,000 codes, there will now be close to 70,000, he said.

The codes are used to denote diagnosis and procedures used, including the reporting of conditions, symptoms and diseases for data collection, research and the like.

Originally, the federal agency had an October 2013 date for implementation of the billing codes, which provide “a more granular reporting breakdown (of services) … and captures data on what’s being treated,” Phillips said.””

(mgnonline.com)