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Medicaid Problem Could Drive Some Colorado Doctors Out Of Business

By Karen Morfitt

DENVER (CBS4) - Doctors across Colorado say they are struggling to get paid for care they've already provided. It stems from issues with the state's new Medicaid payment system that launched in March.

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(credit: CBS)

A spokesperson for the Colorado Hospital Association says they're in the middle of processing information from their own survey, but that initial data indicates hundreds of millions of dollars is owed to hospitals across the state.

As for private providers, many of them say they can't pay their own bills and have had to resort to cutting salaries, taking out multiple loans or borrowing from family -- all in an effort to keep the doors open.

"They are putting their own personal income on the line waiting for the state to actually pay," said a local health care provider CBS4 interviewed who wished to remain anonymous in fear of retribution.

"How much does the state owe you?" CBS4's Karen Morfitt asked.

"Approximately $300,000."

"They can make life incredibly difficult. They can even shut down agencies, and that would be the last thing we wanted," the provider said.

The goal of the new payment system was to better track Medicaid dollars and prevent fraud. It's a program Parrish Steinbrecher with Colorado's Department of Health Care Policy and Financing oversees.

Parrish Steinbrecher
Parrish Steinbrecher (credit: CBS)

"It's an Affordable Care Act requirement whether you've been a provider for two years or 20 years, you have to re-enroll and re-validate and it's different now then it was before," Steinbecher said.

From day one, providers say the system was flawed and their Medicaid bills began piling up ever since.

"It's incredibly difficult the amount of time and energy that is then focused away from the actual day-to-day operations of the agency. And the actual client care is now focused on getting billing through," the provider told CBS4.

The state says they have paid $3 billion in claims since March, but acknowledge there are issues. Steinbecher says a lot of the problems they've seen are from providers not enrolling properly.

"Sometimes they are so busy, we know that, that the communications we've sent out to them they are not always able to get to get that," Steinbecher said.

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(Photo by Tyler Kaufman/Getty Images for MoveOn)

Some providers say their attempts to contact the agency have gone unanswered.

If the payments are delayed any longer, providers say their biggest fear is having to shut down.

"I was thinking within the first 30 days they should have some of the glitches worked out and it would be back to business as usual, but here we are end of August and we are still struggling," the anonymous provider said.

The state has told CBS4 that it has "paid more than $24 million in interim payments to providers experiencing financial hardship. The state says any Medicaid enrolled provider having financial difficulty can request an interim payment by calling DXC Technology at 844-235-2387, press option 2 and then option 4. "

Karen Morfitt joined the CBS4 team as a reporter in 2013. She covers a variety of stories in and around the Denver metro area. Connect with her on Facebook, follow her on Twitter @karenmorfitt or email her tips.

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