Today  the Joint Legislative Oversight Committee on Health and Human Services met at noon. Mr. Joe Cooper, DHHS’ Chief Information Officer, spoke on behalf of DHHS.  He began by explaining that NCTracks is not NC Fast, which I believe we already knew.

Most interestingly, it was stated that DHHS has assessed approximately a quarter of a million dollars in penalties against CSC since NCTracks going live.  These assessments are paid to the state.  To which I ask, “Why does CSC pay penalties to the state? Why not pay the people actually damaged by CSC’s ineptness..the unpaid providers?”  It makes no sense that, while providers are not getting paid, CSC pays the state.  That’s like a robber paying restitution to the insurance company that never covered the losses of the victim.

Another interesting comment was when asked exactly how much has been spent on NCTracks, Mr. Cooper deferred to DHHS’ CFO, Rod Davis who answered that he does not have that information.  To which Senator Tarte stated, “That doesn’t make me feel comfortable.”

Mr. Cooper described CSC’s monumental effort to try to get providers paid.  According to Mr. Cooper the “backlog” will be nonexistent by the end of the year.  But when asked, “What is the number of remaining backlogs?” Mr. Cooper answered, “Senator, I don’t have that number.  I can get it to you.” 

When asked a follow-up question about whether the number of backlogs was similar to a previous number of approximately 43,000, Mr. Cooper noted that there are two types of backlogs.  One backlog addresses prior authorizations, and, according to Mr. Cooper there is no more backlog as to prior authorizations.  NCTracks is absolutely current. The non-current backlog is regarding returning calls and responding to emails.

Providers, Is it true? Is NCTracks current as to prior authorizations?

Mr. Cooper further stated that calls to the Call Center are now answered within seconds. Last week CSC implemented a new process for answering phone calls that when providers call the Call Center, CSC estimates when it will call back the providers in order to stop the providers from staying on the phone too long.  That’s great, but getting an estimated time for a callback doesn’t really resolve the problem, right?

Mr. Cooper also showed a graph depicting total Medicaid claims payments from State fiscal year 2012 through October 2012 (the graph on the left) and payments from State fiscal year 2013 through October 2013. 

Obviously the point of this graph is to demonstrate that CSC is approximately right on track with what HP Enterprises paid last year.  And, I agree, when looking at this graph, it appears that both CSC and HP paid out similar amounts for the different years.  But the graph does not explain whether the volume of claims increased from 2012 to 2013.  One would think that the number of claims increased in 2013, as our population grew.  So is the comparability of the graph deceiving?

Senator Nesbitt pointed out that another graph, the graph depicting claims adjudication, does not appear to demonstrate positive progress.  He said, “It doesn’t look like we are fixing the problem.  We are generating more and more bills that aren’t being paid.”

Here is the chart Senator Nesbitt was talking about:

Senator Nesbitt pointed out that, according to the chart, it looks like claim adjudication is declining.  He sais that he heard someone mention that 70% is the goal, but he doesn’t think that 70% is a good goal.  Why not 100%?

After Senator Nesbitt made his comments, the meeting adjourned until 2:00.  If you want to listen to the committee meeting, click on: http://ncleg.net/Audio/Audio.html.  and select “Appropriations Committee Room (Rm 643).”