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State officials say behavioral health managed-care vendor resolved early payment problems; liquidated damages imposed
Summary
Department of Health and Welfare officials told lawmakers that the July 2024 launch of the Idaho Behavioral Health Plan created system and payment challenges for some providers; the department said the contractor Magellan has returned to compliance and the state has imposed liquidated damages and corrective actions
Department of Health and Welfare leaders told the Joint Finance-Appropriations Committee that implementation of the Idaho Behavioral Health Plan (IBHP) created initial payment disruptions for some behavioral health and federally qualified health centers, but the contractor has addressed many of the issues and is on corrective action.
Alex Adams, director of the department, said the contract scope was large and the department expected “speed bumps” after the July 1, 2024, go-live. Juliette Sharon, deputy director who oversees Medicaid, said the IBHP scope was larger than historical contracts because services previously paid fee-for-service and some behavioral-health functions were consolidated under the new managed-care vendor.
“Magellan did resolve those [provider payment] issues,” Sharon told the committee, adding that the department has “imposed over $100,000 of liquidated damages with Magellan,” issued management letters and placed the vendor on corrective action plans. She said the vendor and department had worked to correct mailing issues, to move providers to electronic funds transfer and to improve provider education about the new system.
Senators and representatives described continuing provider complaints in 2024 about late or missing payments, including accounts reported to lawmakers of clinics taking short-term loans to make payroll while awaiting reimbursement. Sharon said the department monitors timeliness and payment denials, receives monthly reports from the contractor, and continues to work with Magellan to prevent new issues. “They are back in compliance with timeliness requirements,” she said.
The department offered to follow up with individual lawmakers about ongoing provider concerns and said it would continue monitoring performance metrics. Committee members asked the department to keep the legislature apprised of any recurring payment problems and corrective-action outcomes.
Ending note: The committee did not vote on contracts or take formal enforcement action during the hearing; lawmakers pressed for continued oversight and written reports on vendor performance.
