{"id":2951,"date":"2024-06-24T09:45:44","date_gmt":"2024-06-24T09:45:44","guid":{"rendered":"https:\/\/healthynewsusa.com\/?p=2951"},"modified":"2024-06-24T09:45:48","modified_gmt":"2024-06-24T09:45:48","slug":"medicaid-for-millions-in-america-hinges-on-deloitte-run-systems-plagued-by-errors","status":"publish","type":"post","link":"https:\/\/healthynewsusa.com\/?p=2951","title":{"rendered":"Medicaid for Millions in America Hinges on Deloitte-Run Systems Plagued by Errors"},"content":{"rendered":"
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Deloitte, a global consultancy that reported revenue last year of $65 billion<\/a>, pulls in billions of dollars from states and the federal government for supplying technology it says will modernize Medicaid.<\/p>\n

The company promotes itself as the industry leader<\/a> in building sophisticated and efficient systems for states that, among other things, screen who is eligible for Medicaid. However, a KFF Health News investigation of eligibility systems found widespread problems.<\/p>\n

The systems have generated incorrect notices to Medicaid beneficiaries, sent their paperwork to the wrong addresses, and been frozen for hours at a time, according to findings in state audits, allegations and declarations in court documents, and interviews. It can take months to fix problems, according to court documents from a lawsuit in federal court in Tennessee, company documents, and state agencies. Meanwhile, America\u2019s poorest residents pay the price.<\/p>\n

Deloitte dominates this important slice of government business: Twenty-five states have awarded it eligibility systems contracts \u2014 with 53 million Medicaid enrollees in those states as of April 1, 2023, when the unwinding of pandemic protections began, according to the Centers for Medicare & Medicaid Services. Deloitte\u2019s contracts are worth at least $5 billion, according to a KFF Health News review of government contracts, in which Deloitte commits to design, develop, implement, or operate state systems.<\/p>\n

State officials work hand in glove with Deloitte behind closed doors to translate policy choices into computer code that forms the backbone of eligibility systems. When things go wrong, it can be difficult to know who\u2019s at fault, according to attorneys, consumer advocates, and union workers. Sometimes it takes a lawsuit to pull back the curtain.<\/p>\n

Medicaid beneficiaries bear the brunt of system errors, said Steve Catanese, president of Service Employees International Union Local 668 in Pennsylvania. The union chapter represents roughly 19,000 employees \u2014 including government caseworkers who troubleshoot problems for recipients of safety-net benefits such as health coverage and cash assistance for food.<\/p>\n

\u201cAre you hungry? Wait. You sick? Wait,\u201d he said. \u201cDelays can kill people.\u201d<\/p>\n

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KFF Health News interviewed Medicaid recipients, attorneys, and former caseworkers and government employees, and read thousands of pages from contracts, ongoing lawsuits, company materials, and state audits and documents that show problems with Deloitte-operated systems around the country \u2014 including in Arkansas, Colorado, Florida, Georgia, Kentucky, Pennsylvania, Rhode Island, Tennessee, and Texas.<\/p>\n

In an interview, Kenneth Smith, a Deloitte executive who leads its national human services division, said Medicaid eligibility technology is state-owned and agencies \u201cdirect their operation\u201d and \u201cmake decisions about the policies and processes that they implement.\u201d<\/p>\n

\u201cThey\u2019re not Deloitte systems,\u201d he said, noting Deloitte is one player among many who together administer Medicaid benefits.<\/p>\n

Alleging \u201congoing and nationwide\u201d errors and \u201cunfair and deceptive trade practices,\u201d the National Health Law Program, a nonprofit that advocates for people with low incomes, urged the Federal Trade Commission to investigate Deloitte in a complaint filed in January.<\/p>\n

\u201cSystems built by Deloitte have generated numerous errors, resulting in inaccurate Medicaid eligibility determinations and loss of Medicaid coverage for eligible individuals in many states,\u201d it argued. \u201cThe repetition of the same errors in Deloitte eligibility systems across Texas and other states and over time demonstrates that Deloitte has failed.\u201d<\/p>\n

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