Mecklenburg County commissioners on Tuesday will hear from a group of smaller mental health providers about concerns that they’re being unfairly targeted for expulsion from the MeckLINK Behavioral Healthcare’s provider network.
The providers charge that it takes months for them to get paid for their services and that their clients are disproportionately denied certain care.
The county spent more than $7 million to create MeckLINK, classified by the state as a managed-care organization (MCO), to oversee Mecklenburg’s share of millions of dollars in federal Medicaid money for mental health services. It is the only county-run MCO among 10 around the state.
Yet at a meeting last week, the providers told several county and state elected officials that they weren’t getting paid at a reasonable pace after claims were filed and that MeckLINK was rejecting up to half of their clients’ requests for services.
Mark Brown, co-owner of one of the providers, Melange Health Solutions of Charlotte, said the group wants commissioners to appoint an independent review board to review any attempts by MeckLINK to expel providers from its network.
Brown alleged that the expulsions come after “trumped-up deficiencies.”
“We are seeing case after case where administrative errors are elevated to ‘major contract violations’ to justify expulsion,” he said.
At one time, providers billed Medicaid directly for services and faced few denials. But to cut costs, the federal money was turned over to states. N.C. lawmakers put MCOs – including MeckLINK – in charge of deciding which requests for services would be funded.
MeckLINK reported in June that the agency had cut costly intensive in-home treatments from 1,500 clients in March to about 600. It said the cuts were necessary because of cuts in Medicaid funding from the state.
At the same time, MeckLINK Chief Financial Officer Ken O’Neil reported to commissioners in July that it had money problems, running a deficit in May and June.
O’Neil couldn’t be reached Friday.
MeckLINK is in the process of merging into another MCO, said commission Chair Pat Cotham. State lawmakers recently approved a bill that would force MeckLINK to be governed by an independent authority instead of commissioners.
Cotham was one of the officials who met with providers last week.
The allegations, she said, concern her.
“They were no surprise to me; I’ve heard the concerns for months,” Cotham said. “The high rate of denials give me pause. These are vulnerable citizens who may not be getting the services they need.
“We need more clarity. Providers should be able to expect that when they send in a claim for services that they get paid in a reasonable amount of time.”
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