Berger says NC Medicaid delays to get addressed

RALEIGH, N.C. (AP) — The North Carolina Senate’s top leader said Wednesday he’s committed to resolving difficulties with new state computer programs that process Medicaid claims and determine whether people qualify for government services.

Senate leader Phil Berger, R-Rockingham, told the chamber’s ranking Democrat on the Senate floor that fellow Republicans would work with the minority party to address delays related to the Medicaid system and another program, NC FAST.

This will likely involve examinations by an oversight committee made up of legislators that will meet until the General Assembly reconvenes for formal work next May, Berger said.

Both Berger and Minority Leader Martin Nesbitt, D-Buncombe, said they have received complaints from Medicaid providers that they’re having trouble getting reimbursed from the state for services for patients.

“I don’t think anybody thinks it’s working as it should, or as we hope that it will,” Berger told Nesbitt. “I pledge to … the members of this body that we will work together with you to try to find solutions to those problems.”

The program is supposed to handle $12 billion in claims annually from more than 70,000 providers for Medicaid. The new system, built by Computer Sciences Corp., is expected to streamline billing, reduce paperwork and save the state $35 million annually.

Nesbitt said figures show that barely a third of claims in a certain category received during one week in August had been approved.

“I’m getting emails from people who say they’re going out of business if they don’t get this straightened out,” Nesbitt said.

Leaders at the Department of Health and Human Services have said they expected the first few months using the new program would be bumpy as doctors’ offices and hospitals get used to the new system and software glitches are fixed.

HHS spokesman Ricky Diaz said NCTracks approved about 63 percent of medical claims on average last week and since July has processed more than 29 million claims and paid $1.4 billion in claims.

“We look forward to reporting our continuous progress with these programs to legislators,” Diaz wrote in an email.

The Medicaid software program NCTracks began July 1, replacing a legacy system that was first turned on 36 years ago. NCTracks was supposed to come online two years ago. Berger said many decisions about NC Tracks occurred during Democratic Gov. Beverly Perdue’s administration.

NC FAST is designed to help local social services agencies more quickly determine which government services — such as food stamps and Work First — people qualify to receive.

Nesbitt also asked Republicans to examine what some have labeled big raises given to many HHS workers in Gov. Pat McCrory’s administration. Berger said later he didn’t anticipate legislators would examine the raises, saying the executive branch has wide discretion to make decisions on hiring and pay.

Comments are closed.