October 3, 2012

DHHS letter arrived weeks after policy change

Morning Sentinel Staff

A person I know received a letter last week from Department of Health and Human Services regarding MaineCare benefits.

I have a problem with that letter.

The letter states that Ambulatory Surgical Center services are no longer reimbursed by MaineCare. I assume that this prohibition applies only to stand-alone surgical centers, and not to outpatient day surgeries performed in a hospital setting.

Here's my problem with the letter. The letter was dated Sept. 13. The postmark on the envelope was Sept. 19. The real kicker is that this prohibition began Sept. 1.

DHHS notified people of this change three weeks after the change. If a person had a surgery scheduled at an Ambulatory Surgical Center for the first three weeks of September, and the surgery already had been performed by the time the letter was received after Sept. 19, what then?

Oops, sorry, the surgical center bill has to be paid out-of-pocket by the patient, as if MaineCare recipients have a few hundred dollars laying around to pay this unexpected bill with.

I'm not denying DHHS the right to make the change, but it's wrong to notify people about the change three weeks after it took effect. DHHS should not be allowed to deny coverage for this until after Sept. 20, when the letter would have been received.

Phyllis Hyde

Augusta

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