Docs Sue DHHS Over NCTracks Trainwreck

By Rose Hoban

A group of medical practices filed a class-action suit today against the state Department of Health and Human Services over what they call the “negligently developed and designed” NCTracks system, which was implemented as the new Medicaid billing system in the summer of 2013.

In their filing, the seven plaintiffs (see box, below) write that NCTracks “was supposed to be a model of health care information technology that would seamlessly and efficiently process and pay billions of dollars of claims each year,” but instead the rollout was a “disaster, inflicting millions of dollars in damages upon North Carolina’s Medicaid providers.”

The suit names DHHS; lead contractor Computer Sciences Corporation; Maximus Consulting Services, which was contracted to verify and validate the software; and SLI Global Solutions, which was paid to test the system prior to going live on July 1.

One of the plaintiffs, Nash OB-GYN Associates in Rocky Mount, notified lawmakers in late December that it could no longer serve patients with Medicaid.

“We now find that with decreased reimbursement coupled with the time consuming process of receiving payment due to all of the NC Tracks problems that as of January 1, 2014, we will no longer be able to accept new Medicaid patients into our practice,” the physicians wrote in a Dec. 23 letter to members of the Joint Legislative Oversight Committee on Health and Human Services.

In a statement, North Carolina Medical Society head Bob Seligson expressed support for the suit, writing, “We believe that NC Tracks is a poorly tested, defective and very expensive software product.”

Before the launch of NCTracks, multiple red flags were raised to DHHS, including a February 2013 warning offered by risk-management advisor Susan Young, who wrote to DHHS Sec. Aldona Wos that there were “significant risks to successful adoption and use” of NCTracks.

In an audit produced in May 2013, State Auditor Beth Wood also warned that the department had failed to fully test the system and that the testing of NCTracks had major flaws.

The statement noted that the N.C. Medical Society has been working with DHHS, providers and the state to resolve problems for providers. In the six months since implementation of NCTracks, numerous medical providers have complained to state lawmakers and testified before oversight committees about problems submitting bills and getting reimbursed for care they delivered to patients.

Some Medicaid providers have been forced out of business as a result of delays in payment from NCTracks.

“We understand … that legal action may be the only remaining option to remedy the harm to the Medicaid system and get NCTracks to function as advertised,” Seligson wrote.
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