Local/State

Audit shows problems with NCTracks

Monday, December 09, 2013

A new audit of the state's new Medicaid payment program released Monday takes the Department of Health and Human Services to task. It says the agency could have done more to get Medicaid providers paid more quickly.

The program, rolled out this summer, has been plagued with troubles including software glitches and hardware problems. More than 3,000 issues have had to be addressed and some Medicaid providers still aren't getting paid.

The audit says DHHS could have done more to make things right.

Since mid-summer, many businesses that cater to people on Medicaid have had trouble getting reimbursed by the state.

The audit points to 3,200 problems with the state's new payment system called NCTracks. More than 650 of those glitches are still active. Seventy-four percent of those cases are rated as highly severe. The vendor, CSC, is responsible for fixing them.

However, as State Auditor Beth Wood explained, they've largely gotten a pass from DHHS when it comes to how quickly it fixes them.

"They really have no plan to track the vendor against how long it should take to fix them," said Wood. "So, there's no assurance from the department that the defects are being fixed as fast as they should be."

With small businesses literally worried about going out of business because they're not getting reimbursed by the state, time matters.

"Make sure problems are being fixed so vendors are being paid," said Wood. "So that patients can be seen so the system is functioning to the best of its ability."

DHHS did offer a statement from DHHS Chief Information Officer Joe Cooper. It read: ""NCTracks has processed 81 million claims and paid almost $4.5 billion to North Carolina healthcare providers, but it is clear that there is still work to do. While DHHS has a process in place for prioritizing and resolving issues with NCTracks and over 81% of all identified defects have been resolved, we thank the Auditor for her recommendations. It is important to note that the number of defects in NCTracks is significantly less than the industry average for a software system of its size and complexity, and do not affect the vast majority of providers. Our primary focus continues to be to make system improvements and to ensure that every provider is paid for the work they do. But if even one provider is impacted negatively, that's one too many."

The statement didn't specifically address the charge that the agency play a bigger role in getting providers paid more quickly. Wood says that came across in their official response to the audit as well.

"Even their response today doesn't have a plan to fix what's required of CSC," said Wood.

ABC11 reached Durham, Democratic Sen. Floyd McKissick for his opinion.

"It's deeply concerning, said McKissick. "They need to expedite the resolution of the defects that have been identified so that vendors and providers can receive the payments in a timely way."

McKissick did say he's not hearing as many constituent complaints as he heard before.

The audit also took issue with revolving doors in state government and conflicts of interest.

It highlights a state employee who worked closely with CSC quit working for the state and immediately went to work for the vendor.

Wood says the lack of a cooling off period is a statewide problem, but it was her audit of NCTracks that tipped her off to it.

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