State audit slams NC DHHS's rollout of Medicaid billing system

Key findings from a new audit by the NC Auditor's Office on the NC Department of Health and Human Services' disastrous Medicaid billing system, NCTracks:

• "Since going live, the NCTracks system has encountered 3,200 defects.
• "The department has an inadequate framework for the timely resolution of NCTracks defects.
• "The state lacks a comprehensive action plan to address all NCTracks issues.
• "Federal and state government mandated changes have not been implemented within their target or mandatory implementation dates.
• "The state government 'revolving door creates a perception of bias or conflict of interest."

Among the audit's recommendations: "The General Assembly should consider a narrow change to state law to limit the ability of senior level state government employees to go directly to work for a vendor they directly managed whiled employed by the state."


Audit highlights:
A former DHHS employee who served for more than four years as the NCTracks senior program manager and associate program director now works for the NCTracks vendor, [Computer Sciences Corp.], as the NCTracks executive account manager. 
The established contract between the department and CSC requires the vendor to obtain approval from the state for all individuals considered "key personnel." CSC asked the department for approval of this appointment in August 2013. On August 21, 2013, the department approved CSC's request. Auditors found that DHHS and CSC followed established contract procedures.
Without a "cooling off" period, the North Carolina State Ethics Commission has stated that, "even if there is no legal or 'ethical' impediment to doing so, leaving public service to work for a private entity that will do business with the employee's former state employer, may create a perception of bias or conflict of interest. This potential for apparent bias attaches not only to the former employee's subsequent dealings with his former state employer but also to their actions and decisions immediately prior to leaving state employment."
A potential NCTracks certification delay by the federal Centers for Medicare and Medicaid Services (CMS) raises concerns that the state will not begin to save approximately $9.6 million a year at the earliest possible point, July 2014. The state currently pays 50% of NCTracks operational costs. Once the system is certified the federal government cost share will increase to 75% and the state will have to cover only 25% of the costs, resulting in $9.6 million in annual savings. The department has indicated that once the system is certified the state will also receive a federal retroactive reimbursement effective July 1, 2013. 

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