To be sure, the problems with the state’s Medicaid program predate the McCrory administration by a decade or more.
The Division of Medical Assistance, as Medicaid is known, has:
• Overpaid hospitals as much as $400 million for inpatient care in the late 1990s and early 2000s.
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• Overpaid hospitals at least $150 million during the same period for outpatient care in what amounted to interest-free loans.
• Wasted at least $600 million on community support services for mental health programs in the early 2000s; some providers charged up to $61 an hour to take clients to malls or movies or to sit with them in school. Most work was done by employees with high school diplomas.
Perhaps Gov. Pat McCrory’s biggest inherited headache has been two new computer systems. NCFast is used to sign people up for benefits such as food stamps and Medicaid. Problems with NCFast have led to a backlog in Medicaid applications; officials cannot currently come up with the number of Medicaid recipients in North Carolina, a critical number for estimating future costs.
Perhaps an even bigger problem is NCTracks, the state’s new Medicaid claims processing system, which was started during Gov. Mike Easley’s administration. Two years late and more than $200 million over its original budget, the claims system was troubled from the moment the McCrory administration launched it last July.
The system delayed or rejected payments to thousand of doctors, hospitals and other providers. Some physicians went so far as to sue the Department of Health and Human Services, which oversees Medicaid, in January. But another problem lies at the back end of the system, where NCTracks is not producing reliable data for Medicaid users and administrators.
Community Care of North Carolina, a nonprofit that coordinates medical care for 1.3 million Medicaid patients, has been forced to do its job this year without data from NCTracks. CCNC has instead been cobbling together data from hospitals, pharmacies and some medical practices to steer patients to the right care at the right time.
“We’re working to get the data flow re-established,” said Allen Dobson, CCNC director.
CCNC recently received its first batch of data and is testing it now.
Health and Human Services officials say that NCTracks is working, and recently posted a video describing the system as a rousing success.
But Lanier Cansler, a former health and human services secretary who oversaw the development of both NCTracks and NCFast, isn’t so sure.
“I feel better about NCFast in the long run,” Cansler said, “than I do about NCTracks.”