Have you ever bought a used car only to find out it is a lemon? Or a house only to find it is a money pit? Well, I suspect that sinking feeling is much like how Secretary Aldona Wos feels after inheriting the NC Medicaid system.
There is no question that Secretary Wos inherited a lemon…or, even more apropos,…a Medicaid money pit.
Remember, in the January 2013 Medicaid Audit conducted by State Auditor Beth Wood, the audit found Medicaid to be a total of almost $1.2 billion over budget during the past three fiscal years. (FYI: The Fiscal Year begins July 1 and ends June 30. Hence, the need for a new budget now that this Fiscal Year is fast-ending.) The January Audit concluded that (not this year) but the last 3 years, Medicaid was over budget by a total of almost $1.2 billion. The past 3 Fiscal Years were, obviously, before Secretary Wos’ stent as NC Director of the Department of Health and Human Services (DHHS).
Secretary Wos did not only inherit a “money pit” Medicaid system as it pertains to the budget. Think about how expensive NCTracks is turning out to be. But NCTracks was not Secretary Wos’ “baby.” The past administration implemented the new NCTracks system, which is still not “live.” Originally NCTracks was set to go live August 2011 at a cost of $265 million. When the contract was put out for bid in 2008 (for the second time), Computer Sciences Company (CSC) hired former legislator and DHHS Deputy Secretary Lanier Cansler as its lobbyist. Shortly after CSC landed the contract, Perdue named Cansler as her DHHS secretary. (Hmmmm).
NCTracks now brags the hefty price tag of $484 million and is scheduled to go live July 1, 2013. The project is now the most expensive contract in state history.
A new audit released Wednesday says DHHS failed to fully test NCTracks. According to the N&O, “[o]f 834 “Critical Priority Test Cases” set to be performed on the new system, it failed 123. The audit says 285 of the “critical” tests, more than one quarter, were never performed.”
Now many people are criticizing Secretary Wos for the price tag of NCTracks. But prior to pointing fingers, remember from where NCTracks came. And the $1.2 over budget for the last 3 years.
Now this blog is NOT a “let’s all get to together and applaud the new Secretary; we all think she is the bee’s knees; all our Medicaid questions have been answered.”
I am merely pointing out that inheriting a money pit must be a burden. After only five months or so on the job, Secretary Wos has received much criticism; yet many critiques are aimed at “inherited bads.”
Believe me, the current MCO situation (which, although new and may or may not have been Sect. Wos’ doing…although I tend to think not since PBH has been our pilot for years prior) is as catastrophic for the behavioral health providers as a warm day is to Frosty the Snowman.
But at a recent, town-hall-style meeting in Durham, I asked my tugging question. My tugging question for so long has been, “How is the Department of Health and Human Services (DHHS), Division of Medical Assistance (DMA) supervising the Managed Care Organizations (MCOs)?” Well, I asked the question. (Important legal disclaimer…I did NOT ask this question as an attorney. I asked this question as a quasi-journalist for this blog at a public forum. I was NOT representing any party, only my mere legal curiosity).
Sect. Wos’ answer? “Call me.” (These quotes may not be exact…but very close).
“If you have specific questions for specific providers, call me and I will see what I can do.”
Wow! Really? Someone who will actually listen? Well, I got the phone number of her assistant. A Ricky Diaz.
The next day I realized sadly that IF I DID contact Sect. Wos for a specific provider, that as an attorney, if I spoke to Sect. Wos about a specific provider, that I could be accused of ex parte communications with a represented party. And they would be right. So I was stuck between a rock and a hard place. (We’d all be fine if not for these dag on laws…)
So, here we are, a real possibility that going straight to the top could help my clients, but this legal, ethical dilemma overpowers. So I contacted the AG’s office and asked for a telephone conference with Emery Milliken, the general counsel of DHHS, any AG that would like to be involved, Sect. Wos and me. I also contacted Ricky Diaz and asked to schedule a telephone conference with Sect. Wos, me, and whatever counsel Sect. Wos wants.
That was over a week ago.
The lack of supervision over the MCOs has put many good providers out of business, has neglected to provide many Medicaid recipients of their medically necessary needs, has forced so many good providers to fire staff and not provide Medicaid services (due to the MCOs denying services of Medicaid recipients and refusing/terminating Medicaid contracts with good behavioral health care providers).
Call me naive, but I actually think if I spoke to Sect. Wos, she would care and try her best to remedy the catastrophic situation for behavioral health providers. Maybe not. But one can dream.