the Voice of
The Communist League of Revolutionary Workers–Internationalist
“The emancipation of the working class will only be achieved by the working class itself.”
— Karl Marx
May 9, 2022
Hundreds of health care providers in Maryland have had to spend months re-submitting paperwork to a private company to prove they gave services to tens of thousands of the state’s poorest mental health patients. The company, Optum, is trying to snatch back 200 million dollars these health care providers were paid in 2020 and 2021. The duplicate paperwork is an agonizing drain of time for care givers already struggling during the pandemic. Many are being forced to pay back money they already spent. Some are choosing to stop providing services to patients on Medicaid.
In the mid-late 1990s, Maryland, like some other states, introduced a whole new level of for-profit bureaucracy into its public mental health care system, all in the name of cutting costs. In the new privatized system, mental health care providers for 400,000 patients in Maryland submitted their bills to a private company that supposedly reviewed each bill and authorized the state to use federal funds to pay for each service provided, or not. From the beginning critics warned that administrative service companies have an incentive to deny payments for actual care, to make their own bloated contracts look worthwhile.
Maryland bounced the contract from one corporation to another, with the fees rising year by year. One company, ValueOptions, charged 10 million dollars in 2009 even though its software couldn’t tell different health care providers apart, which delayed plenty of payments. But in 2019 ValueOptions demanded four times as much! Maryland switched to a competitor, Optum, which “only” demanded nearly three times as much. But Optum did not bother to solve the same kind of software problems Value Options had back in 2009. That would take hiring people. Optum simply told Maryland to pay each care giver what ValueOptions had paid them. But now Optum says some were overpaid and must repay, and is making them dig up old bills they already submitted two and three years ago.
Privatizing claims processing was all about padding the profits of private companies, while cutting services for poor people with mental health issues.