System crash slows Rx

Maryland's Medicaid pharmacy claims processing system was shut down for several days this month because of a computer disk failure that corrupted the system's database.

The system crashed on Sept. 11 and was restored Sept. 15.

The client-server system links to about 1,200 pharmacies in Maryland.

More than 600,000 elderly or low-income Maryland residents receive Medicaid or other state medical benefits for their prescriptions.

A pharmacist accesses the point-of-sale system to verify a customer's Medicaid eligibility and submit information for billing. The system also tells the pharmacist if the specific medication is covered and what co-payment is due.

But during the four days of system downtime, 'we were operating in the blind,' said Mike Leonard, manager of a Safeway pharmacy in Bethesda, Md. Leonard's pharmacists didn't know if their customers were eligible for Medicaid or not. Leonard and his staff filled customers' prescriptions on 'the honor system,' but it created a backlog of work.

'We had to reprocess all the information when the system went back up,' he said. 'It really was a mess.'
First Health Services Corp. of Richmond, Va., a subsidiary of First Health Group Corp. of Downers Grove, Ill., runs the Medicaid system for Maryland's Health and Mental Hygiene Department under a $4 million annual contract.

About the Author

Trudy Walsh is a senior writer for GCN.

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