DHHS downplayed payment problems while McCrory’s staff juggled complaints

lbonner@newsobserver.comSeptember 26, 2013 

— The state agency overseeing the new computer system that sends money to health professionals treating poor patients downplayed problems with the software even as complaints rolled in to Gov. Pat McCrory’s office from doctors, dentists and medical equipment companies.

Correspondence obtained by The News & Observer from McCrory’s office show that complaints were flowing in from frustrated health care providers, with some appealing directly to his chief of staff and his lawyer, by the end of July.

Those complaints were passed on to the Department of Health and Human Services, which oversees the system.

On Aug. 5, DHHS sent out the news release “NCTracks is on Track.”

Before starting the system on July 1, the department had warned of a bumpy transition to the system built and operated by Computer Sciences Corp. that could last up to three months. The system pays health care providers who treat 1.7 million poor, disabled and elderly people on Medicaid.

Legislators have homed in on NC Tracks’ failings because they’re getting calls and emails from doctors offices and others asking for help. Lawmakers are expected to talk about the system at an Oct. 8 meeting of computer technology and health and human services committees.

As the governor’s office fielded complaints in the first month, one of McCrory’s constituent services representatives, Jeff Moore, sent DHHS spokesman Ricky Diaz an assessment in a July 22 email from Moore’s father, an orthopedic surgeon in Carteret County.

“The new ‘NCTracks’, which is the admin system for Medicaid, is pretty much a disaster. True to form, the person in charge says it is working pretty well. All the doctors’ offices in Carteret County have been without Medicaid payments since it rolled out the first of this month. The system listed me as a provider of fertility services, so when my claims were sent for orthopedic surgery, they were denied.”

In emails, Diaz provided McCrory’s staff with talking points that mirrored agency news releases.

“Keep driving home the point that we’re being proactive in helping providers,” Diaz wrote July 25. “System is working, it’s paying and processing claims. We’re committed to helping them transition.”

In response to questions Thursday, Diaz emailed a statement saying the agency has put “all available resources toward proactively reaching out to providers along with CSC to assist them with this monumental transition.”

The system has processed tens of millions of claims and paid $2.2 billion to health care providers since July 1, Diaz wrote.

“But there is still more work to be done. The Department is issuing hardship payments to struggling practices still having difficulty transitioning to the new system.”

Problems similar to those Moore’s father had persisted into this month for at least one home care agency based in Asheville.

Margaret McGuinn, president of the agency, said Medicaid payments to her company stopped abruptly after receiving a few under the new system. She had problems getting them restarted, even after making a trip from Asheville to Raleigh to make a personal appeal. As she planned a second trip earlier this month, she received the help she needed. She believes the legislators she contacted helped draw attention to her problem.

McGuinn discovered that the computer system listed her home care agency as a birthing center and a child development center.

“It wanted us to have licenses for those, which we couldn’t produce,” she said.

With the problem detected, the company’s payments were pushed through and arrived Tuesday, she said.

“When they get all the problems resolved, it will be a good system,” she said. “Right now, it’s just a mess. We’re afraid to touch anything.”

Bonner: 919-829-4821

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