“Entire healthcare reform program is jeopardized:” White House

“Entire healthcare reform program is jeopardized:” White House

“Entire healthcare reform program is jeopardized:” White House The rampant issues surrounding HealthCare.gov’s financial management platform were the primary cause for the ousting of key IT contractor CGI Federal and the quick appointment of Accenture Federal Services, a 10-page CMS document reveals.

The “Justification for Other than Full and Open Competition” appeared on the CMS website this week, explaining why the government awarded Accenture a $90mn to fix the troubled exchange site without going through the typical six- to 12-month competitive procurement process.

HealthCare.gov “urgently requires” fixes to its “financial management platform,” the document said. The platform is required to provide “stable and predictable financial accounting and outlook for the entire program through administration or risk adjustment.”

The incomplete “back-end” of HealthCare.gov—the financial management platform—already caused an estimated 15,000 applications to disappear within the first three months of enrollment. The data never reached carriers, leaving consumers without proof of enrollment and producers without credit for their sales.

The effect of the debacle led CMS to comment in the document that “the entire healthcare reform program is jeopardized.”
White House spokesperson Jay Carney declined to comment on the document, saying he had not seen it himself, but producers who had client data lost or processed incorrectly can testify to the resulting headaches.

“It’s total chaos. HealthCare.gov has not fully transmitted data and subsidy eligibility to the insurance company,” producer Kelly Fristoe said of the system’s failing. “I’ve been fielding phone calls all day long.”

Sanjay Singh, CEO of hCentive—the IT contractor responsible for building successful state exchanges like those in Kentucky and Colorado—told Insurance Business HealthCare.gov suffered from a lack of thorough testing.

“When you buy on our state exchanges, the exchange is able to send the enrollment data back to the payer whose product was chosen. We enabled that connectivity,” Singh said. “With HealthCare.gov, the backend systems were built but not tested. The first thing that should have happened a long time back was delayed, and by Oct. 1, there was no time to test the backend.”

Singh said he believed HealthCare.gov general contractor QSSI “has done the heavy lifting already” in terms of improving the site, and expressed confidence in Accenture’s ability to make further positive repairs.

Accenture was responsible for the building and launch of Covered California, an exchange Singh rates highly.

“I think they’re operating very well,” he said. “We process their transactions for our carrier clients, and we’re seeing connections flowing at an upward clip. My sense is that it’s one of the more successful state exchanges.”

Larkspur, Calif.-based producer Susan Lundy was less effusive in her praise for Covered California, but admitted it was one of the better exchanges she has worked with.

“Covered California may have blame to be assigned to it, but to be honest, it’s better than some of the others,” Lundy said. “I sell in Oregon and they’re so messed up, you can’t even believe it.”

“Of course, I’m damning with faint praise to say that a really bad website is better than the others, but it pretty much is,” she added.