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North Carolina's Medicaid director leaving post

Posted September 23, 2013

— Carol Steckel is leaving her post as head of the state's Medicaid program after less than nine months on the job.

Gov. Pat McCrory hired Steckel, who had the same job in Louisiana, and before that Alabama, to run what he has consistently described as a "broken" Medicaid program. Now, it appears his chief mechanic of one of the state's most expensive and troubled programs is about to leave the state. 

By way of a news release, Steckel says she has accepted a position with WellCare Health Plans in Tampa, Fla. Her last day will be "no later than" Oct. 11. She reported to Health and Human Services Secretary Aldona Wos. 

"It was a difficult decision to leave DHHS, but this is a great opportunity I can't turn down," Steckel said in a statement. "In just a short time together, we have made good progress on reforming the state's Medicaid program to control costs and improve care. I thank the secretary for her leadership and am committed to making this a smooth transition."

Steckel did not respond to a phone message at her office on Monday. Ricky Diaz, a spokesman for the department, declined to make Steckel available for interviews or further comment on her departure. He did say via email that Steckel was the not the subject of any sort of severance agreement. 

Wos said that Steckel has made "invaluable contributions to the state and the people we serve." She added, "We appreciate her commitment to a smooth transition as we progress towards creating a predictable and sustainable Medicaid system for the people of North Carolina."

In addition to leaving as the chronically troubled Medicaid system is still fighting through a particularly troubled patch, Steckel's departure comes as McCrory has talked up a sweeping reform of the joint federal-state health insurance program for the poor and disabled.

"She was the one with the policy chops driving that," said Don Taylor, a public policy professor at Duke University. "This is going to blowtorch that (reform effort) as well." 

Pushing for managed care

Medicaid covers roughly 1.6 million of North Carolina's 9 million residents. The bulk of those served are children or the parents of children from low-income families, along with pregnant women, the elderly and disabled. The lion's share of the $14 billion cost for the program comes from the federal government, but overruns in North Carolina's smaller share have eaten up savings found elsewhere in the state budget over the past decade.

Carol Steckel, Medicaid director Official's departure could delay planned Medicaid reforms

In Louisiana, Steckel helped remake the Medicaid system, turning much of the service provision over to private companies as part of a managed care model. This year, she helped lead a push for North Carolina to adopt a similar model, but the idea was not received warmly by lawmakers.

Among the businesses that Steckel's new employer, WellCare Health Plans, has is running Medicaid managed care systems in eight states, including Florida and South Carolina. In 2012, the company paid $217.5 million to settle civil fraud allegations with the U.S. Justice Department related to those plans.

"We have to explore more than just commercial managed care," said Rep. Nelson Dollar, R-Wake, a senior budget writer in the House.

DHHS generally and Medicaid specifically have been the subject of tough scrutiny lately, both for high-dollar salaries given to politically connected individuals and a pair of troubled computer systems meant to pay Medicaid health care providers and allow benefit recipients apply for food stamps and other services. That second system, NC FAST, will be the computer network that allows people to apply for health insurance through the federal Affordable Care Act exchanges.

Lawmakers said they were surprised by the departure news Monday.

"We've had some good rapport with her," said Sen. Louis Pate, R-Wayne. 

Leaving before computer issues repaired

Pate said Monday afternoon that DHHS staff had been briefing members of the General Assembly on problems with NC FAST and its sister system, NCTracks. Pate said those staff members were promising that the majority of problems with the two systems would be worked out soon.

Problems with NCTracks have prompted a number of providers to complain they have not been paid for services provided to Medicaid beneficiaries. Steckel will apparently leave the department before those problems are fully ironed out. 

However, neither Pate nor Dollar treated Steckel's departure as a setback for the agency. 

"DHHS always has challenges with reorganization. … Personnel come and go," Dollar said.

Steckel's departure, he said, gives the state "an opportunity to have a restart on Medicaid reform. We want to get it right." DHHS, he said, now can look for someone "who can mesh a little better, create a closer relationship with the General Assembly."

But Taylor said that Steckel's loss will be keenly felt. She had already run two other state Medicaid systems, as well as a state association of Medicaid directors. It will be hard, he said, to attract someone with the same experience. 

"We've lost someone who is really experienced," he said.

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  • StarGazerNC Sep 25, 3:42 p.m.

    What is not included in this story for the WRAL is information about the US Dept. of Justice investigation of health care fraud that resulted in convictions of four top executives of Welcare in June 2013:

    Four Former Wellcare Executives Found Guilty in Florida
    Monday, June 10, 2013

    Just how long has Steckel been anticipating leaving for Wellcare, and what is her position going to be? Looks suspicious.

  • easternNCborn Sep 25, 1:09 p.m.

    "Do the math she was already at DHHS and was hired under Perdue" --

    check the Exempt employee tracker on WRAL. Original Hire Date and Agency Hire Date = 1/22/2013. McCroy took office on 1/5/2013...... Doesn't look like a Perdue appointee. Interested in hearing your facts otherwise.

  • maybelle Sep 25, 12:54 p.m.

    Do the math she was already at DHHS and was hired under Perdue

  • easternNCborn Sep 25, 10:06 a.m.

    lol She was Perdue's baby not Magic Pat's.
    maybelle

    Maybelle -- Please do a little math and reading...She was on the job less than 9 months....That means a McCroy/Wos appointee.

    Also, per N&O article today, the illustrious Joe Hauck (contract crony of Wos) and Mardy Peal (minimal work experience in any field) will have ownership of this. Now if that doesn't scare the citizens of this state, nothing will!

  • maybelle Sep 25, 8:30 a.m.

    lol She was Perdue's baby not Magic Pat's.

  • teleman60 Sep 25, 8:08 a.m.

    Look at the posters here! She's a Magic Pat appointee who, again is racing for the door after only months of work if any!

    We'll be lucky if the state doesn't go bankrupt by Christmas.

    She quit because he/GA turned down the billions that could have made Medicaid solvent.

    And here again MORE FAT JUMPING SHIP PACKAGES! Millions of taxpayer dollars just wizzed away!

    Thanks to them Pat voters!

  • maybelle Sep 24, 5:38 p.m.

    I think NC Fast should be changed back to the old system and get people fed. NOW

  • goldenosprey Sep 24, 3:51 p.m.

    "There is no such thing as NEED this program. The program should NOT exist and never should have existed. The only people getting screwed as you put it are those of us that are forced at gunpoint to pay for it." whatelse

    You can always depart for a country that feels no need to make sure the sick, old and destitute, along with their children, are not left on the roadside to die. Thank God that's not America (yet.)

  • jackjones2nc Sep 24, 2:46 p.m.

    It's time for Aldona Wos to resign.

  • wraluser Sep 24, 2:44 p.m.

    To the point of the ncfast system, wral needs to look into the head of the ncfast project, lots to be found there... just saying...

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