Maryland officials say Carillon largely cleared behavioral‑health claims backlog after Optum transition
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Summary
Deputy Secretary Perry Briskin told the Senate Finance Committee that Maryland’s new behavioral‑health administrative services organization, Carillon, inherited tens of thousands of unpaid claims from Optum but has dramatically reduced older inventories and improved timeliness, while oversight and further reporting continue.
Deputy Secretary Perry Briskin told the Senate Finance Committee on Jan. 29 that Maryland’s new behavioral‑health administrative services organization (ASO), Carillon, has made "significant progress" in clearing a backlog of claims inherited from the prior vendor, Optum. Briskin said Carillon went live Jan. 1, 2025, and began issuing provider payments on Jan. 6.
Briskin said Carillon inherited about 93,000 pending claims at go‑live and that the department has pursued targeted configuration, business‑rule updates and automation to speed processing. He said the overall inventory of older claims has fallen sharply: over‑30‑day claims peaked near 140,000 in April and declined to under 5,000 in December; Briskin said the number was under 4,000 "as of right now." He also highlighted hospital claims as a priority, saying total hospital inventory fell from more than 26,000 in April to under 8,000 in December and that over‑30‑day hospital claims dropped from close to 14,000 to under 500. Hospital turnaround time, he said, improved from about 25 days to 11 days.
On throughput, Briskin cited an average turnaround of roughly nine days for most claims and reported that Maryland processed about 13.1 million behavioral‑health claims in 2025. He also said the department identified and reprocessed previously denied claims, representing an additional paid amount the department described in the presentation.
Carillon’s call center also drew scrutiny during early operations. Briskin said oversight led Carillon to add staff and that call‑center performance improved markedly: average monthly call volume is about 1,700 calls and abandonment rates fell from a peak near 55% to roughly 0.3% in December after staffing and operational adjustments.
Briskin told senators the department has already exacted service‑level agreements (SLAs) in the Carillon contract for metrics such as call center performance, and that the department will withhold payments or pursue remedies if the vendor fails to meet contractual obligations. He said the department will continue intensive oversight, hold frequent meetings with Carillon and providers, and expects more comprehensive reporting visibility in the coming month as legacy Optum data is reconciled.
Committee members asked whether outstanding claims from the Optum period remain; Briskin and Deputy Secretary Alyssa Lord said most inherited claims appear reconciled but offered to confirm details "for the record." Senators also pressed the department on prior audit findings about potential overpayments tied to the Optum era; Briskin said the department will follow up and, where appropriate, defer to legal counsel on active litigation and recovery steps.
The hearing ended with the department offering to take provider‑specific problems and systemic trends for one‑on‑one follow up to ensure persistent issues are addressed.
