Health Care Authority reimburses 36,000 retirees
October 19, 2012 · 5:37 PM
Checks will be mailed next week to 36,000 Medicare retirees enrolled in the state’s Uniform Medical Plan whose 2011 claims were underpaid by an average of about $150 apiece.
About 550 of the retirees were owed more than $500, the agency said, and the value of the entire mailing was $5.2 million. The agency said some underpayments also occurred in 2012 and that those claims would be corrected later as claims are received and processed.
Health Care Authority Director MaryAnne Lindeblad said the issue has been identified and corrected. It occurred during “coordination of benefits,” when portions of the members’ medical claims are covered by both Medicare and the Uniform Medical Plan.
The coordination of benefits process was changed in 2011 because of a misunderstanding regarding claims coordination for Medicare-primary Uniform Medical Plan members. The process has now been restored to the way it functioned before 2011.
“The state is not losing any money in this, since the amounts being reimbursed should have already been paid to the members,” Lindeblad said. “Retirees are not making any money on this either. They are only being reimbursed for payments—copayments, deductibles, or other costs—they should not have made.”
She said retirees who are being reimbursed for $500 or more would receive a personal phone call from UMP Customer Service explaining why they are receiving the check.
“We regret any inconvenience this may have caused our members,” Lindeblad added.