Feds investigate Idaho Medicaid mental-health contractor for privacy violations

2 Sep

A federal agency is investigating whether the company Idaho hired to manage part of its Medicaid program has violated patient-privacy laws.

Optum Idaho, a unit of United Behavioral Health, took over insurance management for Idaho Medicaid’s mental-health and substance-abuse patients last fall.

Local health care providers who treat those patients say Optum has erroneously sent them reports meant for other providers. The reports show patient names and mental-health or substance-abuse services the patients received or were authorized by Optum to receive.

Emails obtained by the Idaho Statesman through a request under the Idaho Public Records Act show that providers have complained to Optum Idaho, the Idaho Department of Health and Welfare, the Idaho attorney general and the U.S. Department of Health and Human Services since October 2013 and as recently as last month.

“We have received multiple authorizations for clients that are not ours (were never ours),” a provider, whose identity was redacted by the Department of Health and Welfare, wrote in January.

Optum says the violations amount to about one-hundredth of 1 percent of the 1.3 million claims it has processed so far in Idaho, and that none has resulted in disclosure of patient information outside the network of providers, who also are prohibited by law from disclosing it.

Idaho contracts with local mental-health and substance-abuse treatment businesses to provide counseling, psychiatric care and other services to its Medicaid patients. Idaho hired Optum last fall to better manage the program’s rising costs.

Source: Feds investigate Idaho Medicaid mental-health contractor for privacy violations | The Business of Idaho Health Care | Idahostatesman.com