NCTracks and DHHS: The Importance of Being Proactive

My daughter came home from school a couple of weeks ago with a bad grade on a test.  I sat her down and explained the importance of being proactive.  I explained that if she knows that a test is coming up that it is her responsibility to study in advance for that test and her responsibility to inform me that the test is coming so that I can ensure that she studies enough (she is only in the 3rd grade, so I still have to check all her homework).  She understood and has been bringing home A’s ever since. 

She gets study sheets prior to a test…she just wasn’t using it.

The importance of being proactive…

To my daughter, being proactive meant the difference in a bad grade and consistent A’s.

Now here we are….NCTracks’ 3-month anniversary!

October 1, 2013, DHHS released a press release touting the “proactiveness” of DHHS dealing with NCTracks issues.  In fact, the word “proactive” is used 6 times in the one page press release.

According to the “thefreedictionary.com,” proactive is defined as: “Acting in advance to deal with an expected difficulty; anticipatory.”

How is DHHS acting proactively to deal with NCTracks problems if the “proactive” measures occur 90 days AFTER NCTracks goes live??????!!!!!

The October 2013 Medicaid Bulletin offers information pertaining to the following topics:

All Providers:

NCTracks Common Issues
Staying Current on ICD-10
NCTracks User Guides Available
Receiving Email Alerts Through NCTracks
NCTracks Contact Information
Clinical Coverage Policies

4 topics with information germane to NCTracks.  And there is quite a bit of information within each topic.

In the June 2013 Medicaid Bulletin (the month prior to NCTracks going live), this is the information DHHS provided:

NCTracks is a multi-payer system that will consolidate several claims processing platforms into a single solution for multiple divisions within the N.C. Department of Health and Human Services (DHHS), including the Division of Medical Assistance, the Division of Mental Health, Developmental Disabilities and Substance Abuse Services, the Division of Public Health, and the Office of Rural Health and Community Care.

The new NCTracks system will go live on July 1, 2013. In advance of that date, there are a number of things that providers can do to prepare for the transition, including taking advantage of upcoming training opportunities.

The June Medicaid Bulletin also provided info as to signing up for emails with NCTracks and the checkwrite schedule.  But nothing as thorough as the October Medicaid Bulletin.

Sure, you can make the argument that DHHS could not have provided more information prior to going live because DHHS had no idea what future problems there would be.  Obviously, DHHS also cannot foretell the future.

BUT….DHHS DID HAVE ADVANCE WARNING OF POSSIBLE ISSUES.

Remember the May 2013 Performance Audit conducted by the State Auditor Beth Wood?

One of the recommendations in the Performance Audit was that “[t]he Department should re-evaluate its current “Go” decision for July 1, 2013, once final Go/No-go criteria is established and documented. This assessment should incorporate the final user acceptance testing and production simulation testing results.”

Finding #5 shows that DHHS had no “go-live” criteria to even determine whether NCTracks should go live.

Finding #3 states that the assessments for NCTracks were live and put system readiness at risk.

Finding #2 states that the production simulation testing is flawed.

Finding #1 states that hundreds of critical user test cases were not conducted.

Before a test, my daughter has a study sheet to review…to make sure that she is fully prepared for the test.  Similarly, DHHS had a Performance Audit to review…to make sure DHHS and the Medicaid providers were fully prepared prior to going live.

Unlike my daughter, DHHS failed to study.

The importance of being proactive…

About kemanuel

Medicare and Medicaid Regulatory Compliance Litigator

Posted on October 3, 2013, in Accountability, Beth Wood, Computer Sciences Corporation, CSC, DHHS, Health Care Providers and Services, Medicaid, Medicaid Audits, Medicaid Reimbursement, Medicaid Services, NC, NCTrack Glitches, NCTracks, NCTracks Billing Issues, NCTracks Performance Audit, North Carolina, Office of State Auditor, Timely Payments and tagged , , , , , , , , , , , , , . Bookmark the permalink. 5 Comments.

  1. Geoffrey Zeger, ACSW, LCSW

    SPIN spin sugar!!!

    Below is an article about the SPIN from DHHS…Ricky Davis (the highly paid 20 something communication point person) was pushing ‘talking points’ back in July like “Keep driving home the point that we’re being proactive in helping providers,”

    http://www.journalnow.com/news/state_region/article_86fb5de2-271d-11e3-8ec3-001a4bcf6878.html

    If you keeping saying ‘proactive’ will people eventually believe it?

  2. Exactly!!!! Just keep saying it!!

  3. palladiumsubbie

    They are being “proactive” by predicting that the providers will _continue_ to have problems until this mess is resolved! By acknowledging those “future” problems, they are being “proactive.”

  4. palladiumsubbie

    This is the worst comment from that article…

    “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.”

    The practices aren’t having difficulty transitioning to the new system! NC Medicaid is!

  5. The worst part of this whole mess is the fact that sick, helpless individuals who qualify for especially medications have and are going without the needed and prescribed medications. Terminal individual, individuals in pain, sick children and simply individuals whose physicians prescribed these drugs are doing without, suffering and getting worse. Cost effective, I think not. I know from personal experience that the staff at HHS also believed that NCTRACTS was not ready to go state wide. Why did they? The result was once again that the individuals that they are paid to serve are the ones who suffered. Are they always going to be lost in the system?

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