Comments on: Firm faces big fine, possible loss of contract, state says (updated!)

By: krflock42

krflock42 — Fri, 30 Apr 2010 10:16:01 +0000

lets face it , Optum is out for major profits! my agency has not received any payment since December 09. then they cut rates again for services, and prorated back to December of 09, I have worked in health care , rather behavioral health for more than 15 years I am not a business major nor ever will be , be even i understand that what they are doing to our state , agencies and other providers is not a way to run a business. New Mexico needs to reclaim their state, provide their own behavioral health care from with in not contract out, the figure runs to approx 5 million dollars goes to Optum for profit per month. wouldn't it be better if the money stayed in the state and let a non profit org run the program as it was done in the early 90's. As it stands now our state legislators are meeting soon and on the agenda ( see the NM web site) major cuts to medicaid programs not just to mental health but to all the other programs sponsored under this program.We tell people to look at history and learn from it, isnt it about time our state did?

By: Guest

Guest — Tue, 23 Feb 2010 18:14:35 +0000

It' s the end of February and we are still not receiving payment for the services we provide. The worst part is we never know what we will be paid until the payment arrives (or doesn't). Each week on Wednesday or Thursday, we receive a notice saying we will have an automatic payment (on Thursday or Friday). It of course doesn't tell us how much the payment will be but I've come to understand it will NOT be for the total amount owed.

We should be receiving between $2500 and $3000 a week and we are stuck receiving $800. or $600. sometimes we are lucky and we receive a larger check but other times, like Thanksgiving week we received $00.00 because they denied 3 claims from previous MONTHS!! I don't know where the claims go or why they 'hand select' what will be paid but it's impossible to run a business like this. This type of problem is why providers choose NOT to provide service to Medicaid clients.

Interestingly enough I don't blame Optum Health, I blame the elite group on the Governors TASK FORCE for selecting a company with a horrible history of problems. As far as I know the committee is comprised of representatives from all the BIG agencies, CYFD, FYI, SOUTHWEST etc. They are the ones who disliked VO and insisted on changing. I certainly didn't receive any survey for MY opinion and I'm sure none of the other small businesses in the State were asked what they thought. The representatives decided on Optum Health and then we were TOLD of the change. We weren't even given a decent advance notice of the change. The change was forced on us when we had NO PROBLEM with VO. And WHO had the problem with VO??? You guessed it, the BIG agencies.

I have heard there is a class action suit and if anyone has information about it PLEASE notify me. I personally hope it's against the task force since they were the ones responsible for this mess.

By: Guest

Guest — Tue, 23 Feb 2010 12:14:35 +0000

By: njcampbell

njcampbell — Tue, 23 Feb 2010 11:14:35 +0000

By: melissag8893

melissag8893 — Wed, 20 Jan 2010 15:43:13 +0000

They need to get out of our state, they are not doing what they are supposed to be doing. Plain and simple they are not following the contract get them out!! All the citizens of New Mexico that are in need of the services are not getting it so why keep them around. Secondly I will never understand why our state can not manage thier own money to pay these claims anyway, its ridiculous were paying somebody to spend our money, Get rid of managed care it is not worth it. We have the legislature sitting around a table today trying to figure where they can cut money because of shortfall DUH take it away from optum, manage the money ourselves, create jobs for New Mexicans!! Err

By: eekeller

eekeller — Wed, 04 Nov 2009 17:43:14 +0000

My partner works for these THIEVES. They pay their employees a pittance – no matter how long you are with the company, AND they make each employee pay for his or her medical benefits. They spend most of their time trying to get around regulations and trying to keep as much of the outrageous premiums they collect – by STALLING & DENYING.

By: eugeneandrewreidjr

eugeneandrewreidjr — Wed, 04 Nov 2009 14:37:57 +0000

The current contractor is not living up to the promises made to the Indian tribes. It seems big Navajo is reaping the services. The Tribal Governors and Leaders should be invited to the table and there should be some transparency as to what is available; these services don't seem culturally sensitive (what services-Region VI is getting top dollar and I don't see them in the tribal communities). As usual more broken promises.

By: southvalley

southvalley — Mon, 02 Nov 2009 21:42:07 +0000

I know quite a few people who really NEED these services. But they aren't getting them. Is it because of THIS?

By: Dr Benway

Dr Benway — Mon, 02 Nov 2009 17:54:47 +0000

Why you ask, because we're nothing but harmless chumps to them – fools who continue to mill around just waiting to be fleeced.

By: ElmerChavez

ElmerChavez — Mon, 02 Nov 2009 12:57:38 +0000

It's really just a nother manifestation of pay to play politics and an expensive solution to a problem we didn't have. Work was consolidated and given to the highest conrtibutor. It was a trainwereck for provders for a couple of years with the same kind of payment problems. About the time those problems were resolved, the contract expired and ValuOptions got outbribed by Optum, and had the audacity to complain about. Shockingly, we began experience payment problems again. It's sort of circular in the land of manana. This stuff costs us all more than we know.