The claims filing system used by the private firm handling Louisiana’s behavioral health programs led to cuts in personnel at two south Louisiana human services districts, the legislative auditor said Monday.
The legislative auditor found that the computers used by Magellan, the private contractor that handles the invoicing, is not set up to bill “third parties,” such as insurance companies, for services that had been delivered. The auditor found that only a fraction of the money owed was collected, leaving the two districts short of the money state government had expected the districts to generate on their own. The state Department of Health and Hospitals sets the districts’ budgets.
“The inability to achieve budgeted revenue is absorbed primarily through not filling vacant positions. With vacant positions, its caseloads and waiting times have increased, resulting in drops in services,” the auditor concluded. They have been far short of meeting self-generated revenue targets because of Magellan’s “system limitations and flaws.”
The auditor focused only on the two agencies. Other districts, such as the one covering the Baton Rouge area, opted to do their billing through another private contractor, not Magellan.
Magellan took over in March 2012 as Gov. Bobby Jindal’s administration privatized the management of the state’s behavioral health services.
Magellan did not respond to the legislative auditor and did not return a call from The Advocate requesting comment.
Department of Health and Hospitals Secretary Kathy Kliebert said late Monday the first-of-its-kind program, led by Magellan, has improved behavioral health care access by increasing providers, such as psychologists and social workers, from about 800 to 1,700.
“But as with any new program, there is an adjustment period,” Kliebert said. “We expect that the system will continue to improve as we move into the second phase of the partnership with the new contract next spring, which incorporates additional changes for better claims process.”
The Florida district, based in Hammond, collected approximately 13 percent of its budgeted self-generated revenue for fiscal year 2013 — $388,438 compared with $3 million anticipated — and only 49 percent for fiscal year 2014, some $1.49 million compared with $3 million, according to the report.
Meanwhile, the Acadiana district, based in Lafayette, collected approximately 37 percent of its self-generated budget target in fiscal year 2014 — its first year of full operation. Fees and revenues totaled $824,806, compared with the budgeted $2.2 million, the auditor reported.
Acadiana’s Executive Director Brad Farmer said some corrective action has been taken but problems still linger with the claims filing system Magellan uses. He said the district has regular conversations with Magellan “to work through things.”
Farmer said the agency is looking at getting away from Magellan’s system like other human services districts have done.
Legislative Auditor Daryl Purpera released separate reports on each district. The reports were done “to evaluate certain internal controls the districts use to ensure accurate financial reporting and transparency, compliance with applicable laws and regulations, and to provide overall accountability for public funds.”