Medicaid Mammogram Mumbo Jumbo?

Check this from the Austin American-Statesman:

Texas doctors are turning away poor women who are eligible for digital mammograms because they say the state Medicaid program won’t pay for the procedure, although officials claim the program does.

Texas health officials said in December 2005 that they would use state-administered Medicaid money to pay for mammograms that use new digital technology. But the state admits that it has failed to give doctors a clear way to bill for the procedure.

The result is that doctors across the state who have switched to digital mammography have been refusing to examine Medicaid patients, saying they believed they would not be paid.

You have got to be kidding. Women are going without mammograms because the state cannot get its act together concerning billing procedures?

This is sadly typical of the state’s overall failure to appropriately manage and administer essentially all of its Health & Human Service programs.

And, like many other HHS debacles, this one is ripe for litigation which could cost the state millions. How many women denied mammograms could have caught cancer early? Who knows?

There is more:

The confusion over whether Medicaid will pay for digital mammograms is complicating efforts by health officials to increase the number of women in the state who have regular breast cancer screening. Texas ranks 42nd in the nation in mammogram rates, according to data from the federal Centers for Disease Control and Prevention.

The majority of mammograms in Austin are digital, and hospitals with older equipment are planning to convert within the next few years.

Texas health officials declined repeated requests by Cox Newspapers to be interviewed. But a spokesman for the Texas Health and Human Services Commission said in a statement that although “digital mammography is a covered benefit in the Texas Medicaid program,” the state did not give doctors a clear method for billing for the procedure. The statement also said the government is trying to correct the problem.

It is unclear how many women trying to get a mammogram have been turned away by doctors, but Medicaid officials say they rejected more than 6,000 claims last year because they were for digital mammograms.

So, they claim they are trying to correct the problem. And, 6.000 people have been denied mammograms.

How hard can it be to correct this problem? A letter to every physician accepting Medicaid in the state? That’s easy to do. Fixing a computer program? That’s easy, too.

So, why hasn’t the state fixed the problem?

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