Action needed as Medicare failures continue
A Victorian aged care peak body has called for the Department of Human Services (DHS) to take definitive action and publicly commit to timelines to resolve the critical IT system failures within Medicare that are reportedly affecting community and home care providers’ ability to deliver care and services to older Victorians.
Definitive action is needed to resolve the critical IT system failures within Medicare that are reportedly affecting home care providers’ ability to deliver care and services to older Victorians.
Leading Age Services Australia – Victoria (LASA Victoria) president, Ingrid Williams, says the issues, which have now continued for more than 12 months without a solution, have reached crisis point for the industry.
The problems reportedly arose after industry reforms led to the implementation of a new IT system that providers were required to use in order to claim care payments from Medicare.
“From the outset this system, which was clearly not adequately tested for industry use, was flawed and has caused substantial delays and associated problems for providers in receiving the required payment information for the older people they care for,” Ms Williams says.
She claims the problem is now “so extensive” that most providers are two to three months behind in determining and receiving the correct payments; which in some cases would equate to hundreds of thousands of dollars in outstanding money.
“They are also receiving complex payment summaries with multiple entries which cause difficulty with reconciliation and determining what the exact amount should be,” she adds.
“These problems have resulted in a significant administrative burden for providers as they are forced to use the old manual claiming and reconciliation system, one which takes a number of days to reconcile each month’s information. They are also unable to comply with prudential and year end reporting requirements.”
In addition, Ms Williams says members are repeatedly receiving erroneous information and hearing conflicting advice from within Medicare itself.
“The level of inefficiency, frustration and concern this is causing is simply unacceptable for our members who strive every day to provide quality care and services to vulnerable, older Victorians.
“Despite LASA’s repeated liaison with the DHS, on both a State and National level, over the past year these problems have, to this point, only escalated. As the industry is almost due for the second lot of means and asset tests, this will once again intensify and magnify these issues.”
At a recent meeting in Canberra, senior DHS staff told LASA that the IT system had recently been brought back 'in house' in the latest attempt to rectify these issues.
“We hope this proves a positive step, however the industry is still without any commitment from DHS to a comprehensive action plan and timeline to ensure a complete fix. From past experience, we are deeply concerned that these issues will continue deep into 2015 if DHS is not held accountable to a public timeline.
“We believe part of the solution involves additional one on one resources being made available for community and home care package providers to once and for all reconcile all previous issues and get payments aligned and up to date.”
