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05/02/2016

Department of Human Services, GO-TIME Launch an Online Portal to Save Money by Avoiding Improper Medicaid Payments

Harrisburg, PA - The Department of Human Services (DHS) and the Governor's Office of Transformation, Innovation, Management and Efficiency (GO-TIME) announced today that Pennsylvania has implemented an online customer portal for Third Party Liability (TPL) that will modernize and streamline case processing to help ensure that Medicaid does not pay for services that should be covered by private insurance or another liable third party. 

“By using technology to improve our Third Party Liability program, we can make sure that Medicaid tax dollars are spent only when it is appropriate and that private insurance will pay when it should,” said DHS Secretary Ted Dallas. “The new portal will help us work more efficiently and reduce waste.” 

DHS is on track to collect approximately $613 million by the end of the fiscal year for cost of care payments initially made by Medicaid that should have been covered by private insurance. This collection is up from $582 million the previous year. The TPL portal will make it easier to process these cases and should further increase the amount collected each year.

The portal will increase the speed with which cases are opened and processed and ultimately resolved. Not only will the portal improve customer service, it will ultimately help ensure that private insurance pays when appropriate. This increased efficiency complements improvements in processing payments that were made in the last year, including:

o   Reducing the time it takes to establish costs in a new case from 77 days to 25 days;

o   Decreasing the backlog of those cases from 2,124 to 930; and

o   Driving down the time it takes to open a case from 120 days to just three days.

The portal will enable attorneys, insurers, and the public to more easily make referrals and upload documents rather than fax or mail them. The portal can be accessed by visiting the Estate Recovery Program website.

Through GO-TIME, the Wolf Administration is working to increase efficiency, improve service, and generate savings through inter-agency collaboration, external partnerships, and citizen engagement. To date, the office has identified over 200 projects expected to generate up to $150 million in savings in the current fiscal year.

MEDIA CONTACT: Diana Fishlock - 717-425-7606

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