LUMBERTON — Changes in the way Medicaid and Food Stamp applications are received and benefits disbursed are still causing problems for Robeson County resident who are receiving the benefits.
A new North Carolina Medicaid billing system continues to fall short on addressing defects months after coming online in the summer and on completing government-mandated changes on time, according to an audit released on Monday.
A second system that is supposed to make it easier and more efficient for food stamps and Medicaid applications and benefit disbursements is also still plagued with glitches, Anthony Dial, a program administrator with the Robeson County Department of Social Services, said this morning.
State Auditor Beth Wood’s office released a follow-up to an audit in May that found NCTracks hadn’t been fully tested in advance of the July 1 start. The new report, which examined roughly the first four months of operations, said NCTracks has encountered more than 3,200 program defects.
The audit is another poor mark for NCTracks, which replaced a system that first began in the 1970s. An outside vendor is getting paid $484 million to build and operate the system, which has received complaints from doctors’ offices and hospitals about being denied claims payments and receiving little assistance from the vendor-run help desk.
Leaders of the Department of Health and Human Services, which manages Medicaid, and Computer Sciences Corp. have acknowledged problems at legislative oversight committee meetings. But they said many early claims and call center troubles have been addressed.
As of early November, about one-third of the defects focused upon the NCTracks web portal, which tens of thousands of medical providers are expected to use, the audit said. Problems have included functions to check patient eligibility for services, the status of claims and updating provider data.
In a formal response from DHHS attached to the audit, the department largely agreed with recommendations but also said the number of defects were lower on average for a similarly situated computer program in the private sector.
DHHS has targeted response times to address defects, such as 24 hours for a “critical” system-wide failure. But the agency gave conflicting information about what a “response” means, the audit said.
The report found 12 of the agency’s 14 top system changes that are mandated by legislation or regulation weren’t in place by their target or required dates. In the attached response, DHHS said it’s working to implement all outstanding change requirements by March 1.
Most of the price tag for building the project is being paid by the federal government. The state currently pays 50 percent of the system’s operational cost, but it will fall to 25 percent once the federal government certifies the system.
NCTracks is expected to pay out more than $12 billion from 88 million claims filed annually for Medicaid, the federal-state health insurance program for more than 1.7 million North Carolina residents.
Dial said that his agency has no control over the operation of NCTracks.
“In the past we could call a (Medicaid) provider and let them know a new client was being processed and would be approved,” Dial said. “But now we can’t do that.”
Dial said that the problems immediately plaguing his agency center on the new computer system NC FAST. Dial said that currently new Medicaid applications are being immediately put in the NC FAST system while the files of those who have been receiving benefits are being keyed into the system.
“We are still seeing glitches in the system. Sometimes its down for a couple of hours until it can be corrected,” he said. “All of the files for Medicaid are supposed to be converted and in the system by Jan. 22, but our director (Becky Morrow) has asked that we have an extension until March.”
Dial said that staff at his agency has been working “diligently” and putting in a lot of overtime to ensure that Robeson County recipients of food Stamps and Medicaid receive their benefits in a timely fashion.
‘It’s been rough,” Dial said. “We are getting calls daily from those asking questions about their food and Medicaid benefits.”
Staff writer Bob Shiles contributed to this report from the Associated Press.