Elyria family, critical caregiveres report MyCare Ohio payment delays

Some care agencies not paid since April 30

ELYRIA, Ohio - Lynn Kiley does everything she can for her 35-year-old daughter Maureen at their Elyria home.

Her daughter suffered a traumatic brain injury several years ago and now relies on critical in-home and out-of-home care provided my the new MyCare Ohio managed care program.

The program is now being launch in 29 Ohio counties, and is expected to serve more than 114,000 Ohio residents who have both Medicare and Medicaid.

However, Kiley reports her daughter's caregivers have been helping her daughter without pay since April 30.   

"She needs the people to help her, and right now they have been working without any pay at all, and it's been going on for over two months now," explained Kiley.

"They're good people, they provide for many different clients. They can't just operate without some kind of money coming in."

Kiley contacted the 5 On Your Side Solution Center after she made several attempts to contact Medicaid and United Healthcare about the delays in funding.

"I've made numerous calls to Medicaid and United Healthcare," said Kiley. "I've talked to many people, I've been transferred from one person to another. I get different answers depending on who I'm talking to."

The Lucy Idol Center in Vermilion is one of the agencies that provides important care to KIley's daughter.

Lucy Idol Executive Director Tad Peck told NewsChannel5 the lack of payment from the MyCare Ohio program has left his agency frustrated.

"I believe that we followed all the steps that we needed to be compliant, and yet we're still having an issue," said Peck.

"It's a communication situation as much as anything. I believe that it will get resolved, but it's the amount of time that it's taking for that occur."

NewsChannel5 contacted both the Ohio Department of Medicaid and United Healthcare Services about this case, and both agencies responded immediately.

The Ohio Department of Medicaid agreed to reach out to both of Maureen Kiley's caregivers in search of a solution, and explained it has already successfully signed up more 100,000 clients to the new three-year program.

United Healthcare quickly contacted the Kiley family in response to our story, and issued the following statement:

"We are reaching out to the providers you have mentioned, and are working with them working directly to understand their issues and process payments."

Our Company provider advocacy teams have conducted extensive outreach, provided WebEx trainings, direct mail resources and more, to assist providers as they enroll in new payment systems for MyCare Ohio.

We encourage any provider who has questions about our partnership or wishes to participate with in the MyCare Ohio program to call 1-800-600-9007 or email us at icdsprovider@uhc.com."

Meanwhile Kiley is hoping provider payments will start soon, she's worried critical care for daughter could be interrupted.

"I wish they'd get their act together and figure out what's going on," said Kiley. "I think it seems like Medicaid just handed this program off to three different insurance companies to administer, and they don't seem to know  what they're doing."

NewsChannel5 and newsnet5.com will continue to follow-up on this developing story.

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