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DHHS staff defends troubled NC Medicaid software

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RALEIGH, N.C. -

The technology chief at the state Department of Health and Services told legislators Tuesday the agency's new computer system for processing Medicaid claims is working well, despite a critical audit and complaints from medical professionals.

Chief Information Officer Joe Cooper said the state staffers overseeing the NCTracks system should be "congratulated on seeing this project through a successful launch." Cooper said the agency is constantly making improvements to the system, but that on the whole, it is performing well.

That assessment is in sharp contrast to an audit of the NCTracks system released Monday by State Auditor Beth Wood. The audit said the system continues to fall short on addressing defects months after coming online in July and on completing government-mandated changes on time.

The auditor's report, which examined NCTracks operations through October, said the software has encountered more than 3,200 program defects and that contractor Computer Services Corporation has an "inadequate framework" to address the problems.

Doctors and dentists who serve Medicaid patients have complained loudly about NCTracks, saying routine reimbursement claims too often are delayed, if they are paid at all. The North Carolina Medical Society, which represents the state's doctors, issued a statement Monday expressing hope the new audit would spur "definitive action" to "fix NCTracks once and for all."

Cooper made no direct mention of the audit during his presentation, but did note that about 80 percent of the software defects identified so far have been corrected.

"Our first priority has been and will continue to be to reimburse all providers that continue to serve our state's most vulnerable citizens," Cooper said.

Cooper said the system has paid more than $4 billion in claims so far in the current fiscal year, a number similar to what was paid out in the same period last year under the old system.

More than $255 million in state and federal funds have been spent on the project so far, with costs budgeted to grow to $484 million by 2020.

Wood, a Democrat, sat in the audience during Cooper's presentation. Her spokesman, Bill Holmes, said afterwards that Wood had sent word to the Republican chairman of the legislative oversight committee that she was available to answer any questions, but was told that "would not be necessary."

Wood said afterward she disagreed with Cooper's characterization that the NCTracks rollout was "successful."

"Our office has seen no evidence to support that statement," Wood said. "In fact, I have three audits that contradict that statement."

Democratic Senate leader Martin Nesbitt, D-Buncombe, said Tuesday he is still hearing from medical providers having chronic problems with NCTracks, nearly half a year after its launch.

He expressed concern to that Republican legislators weren't pressing hard enough to fix the buggy software out of concern for embarrassing the GOP administration of Gov. Pat McCrory.

"I think the auditor has hit the nail on the head," Nesbitt said.

Nesbitt said there needs to be a "firm discussion" on NCTracks. He said North Carolina is running "the imminent risk" of beginning to lose caregivers.

"As I read the audit, the auditor is questioning a lack of real goals to solve the problem and that's what this committee has been upset about from the beginning," Nesbitt said. "And basically, they have targets which may or may not be met, but I believe the thrust of the audit is we're not getting anywhere really fast."

Nesbitt called it "a very real threat" that the state could start to lose providers.

"They've maintained for years that they lose money on Medicaid patients, but they're willing to do that because that's better than people not paying at all," Nesbitt said in an interview with WNCN. "And that's helpful to them, because basically we provide that everybody has to be cared for especially at the hospitals, so they're will to do it.

"Now they're saying, ‘If I have to wait 90 days, if I've got to front the money for 90 days to pursue this losing proposition, I'm not going to do it. The state should pay us in a timely manner, if they're going to set the rates where they are or it's simply just not worth doing. I can't afford to finance the state of North Carolina.'

"And I've said this over and over again here, we're the biggest consumer in the state of North Carolina. If we don't pay our bills, the economy cannot recover."

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