Local Politics

Year after launch, NCTracks still getting mixed reviews from medical providers

One year after the troubled launch of North Carolina's new half-billion-dollar Medicaid billing system, the state's health department says the system is working well. But not everyone is pleased with the progress of NCTracks.

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RALEIGH, N.C. — One year after the troubled launch of North Carolina's new half-billion-dollar Medicaid billing system, the state's health department says the system is effectively paying medical providers for patient treatment.

But not everyone is pleased with the progress of NCTracks, a complex technology project meant to streamline reimbursement to providers and make it easier for policy-makers to track Medicaid costs. Some doctors, clinics and other providers say they're still having trouble getting the money they're owed.

While state officials acknowledge there were issues when providers began using NCTracks on July 1, 2013, they say the system is working well and is a vast improvement over its 35-year-old predecessor.

“We went from a system that was very paper-based – lots and lots of paper forms – to now a system that is almost totally electronic,” Joe Cooper, chief information officer for the state Department of Health and Human Services, said. “A lot of progress has been made, and we feel very good about where we are.”

Jacob Rodman, of the Raleigh Neurosurgical Clinic, says that, although there's no doubt NCTracks has gotten better in the last year, the state still has “a long way to go.”

“It is not fixed,” Rodman said. “I think as far as ease of use for providers as it stands today, the consensus is the old system was better.”

The challenges with the system have been frustrating for other providers, such as Tonia LaRouche, of Health Innovations Pharmacy. In August, she told WRAL News the state owed her practice at least $30,000.

That amount is now down to just thousands for the small practice in Southern Pines, but the improvements haven't been universal.

“My biggest frustration is that I can't keep up with day-to-day operations because of this,” LaRouche said late last month. “We're backlogged because we have other insurance companies that we have to deal with. Medicaid takes a whole lot of time because of every step you have to go through.”

Rodman said he has nine open technical complaints waiting for resolution by Computer Sciences Corp., the company paid $484 million to develop NCTracks. The original 2009 contract for the project was for $265 million before a two-year extension approved in 2011 under Democratic Gov. Bev Perdue's administration.

State audits have been critical of those contracts and have also raised issues with the implementation of NCTracks under DHHS Secretary Aldona Wos, an appointee of Republican Gov. Pat McCrory.

Five-and-a-half years later, DHHS officials say CSC has been fined $1.4 million for failing to deliver “certain levels of service.” Despite those penalties, Cooper said the company's “been a good partner” during the project, which has so far paid out more than $10.3 billion for 200 million claims, almost all of which are paid within a week.

“I remind people that we have 97,000 providers, and you would expect that there is always going to be a few people in 97,000 providers that still have issues,” Cooper said. “But as we get them, we address them very quickly.”

Cooper notes that among the criticisms, there are also plenty of positives, such as the $3 million the department says it saves taxpayers every month by using one streamlined system.

Some say they're happy with the changes.

In a video released by DHHS on Monday, several medical providers praised the performance of NCTracks.

“It allows me to provide the type of care for my patients that I'd like to provide for them,” Scott Jensen, an oral surgeon in Greensboro, said in the video. “We have money to help the business grow so we can continue to provide the services patients have come to expect.”

While acknowledging its rocky start, Chris Lonon, with Home Instead Senior Care in Monroe, said NCTracks has seen dramatic improvement over the last year.

“I wouldn't say by any means it was great at the beginning,” Lonon said in the video. “But it's so much better a system once they worked all that out. I don't think there would be anybody that would tell you it's not a better system.”

They also said NCTracks allows quick notification of billing errors, meaning they get paid much faster. Cooper said that's one of the signs the system is working the way it's supposed to.

“We are paying claims very effectively, very efficiently, and any provider out there that doesn’t feel right about how they’re being paid, I’d like them to reach out to me personally,” Cooper said.

He added that providers having trouble could call his office at (919)855-3000 for help.

Some doctors and other medical practitioners have gone beyond lodging complaints with the department and CSC. In January, a group of providers filed a class-action lawsuit against DHHS, CSC and two other companies involved with the project, claiming "NCTracks has been a disaster, inflicting millions of dollars in damages upon North Carolina’s Medicaid providers.”

Rodman worries that, if the Medicaid payment process doesn't improve, it may force some medical providers to avoid the frustration altogether.

“These are the sickest of the sickest,” Rodman said of his Medicaid patients. “These are the patients that need care, need guidance, need providers the most in our society, and if we get to a point where people stop accepting Medicaid patients or new Medicaid patients, that could be disastrous for the health care system of North Carolina.”

Editor's note: This story has been updated to include Department of Health and Human Services Chief Information Officer Joe Cooper's office number, as well as a link to the DHHS video interviewing providers. The video for this story was edited to remove a portion of an interview showing Cooper laughing after a segment overviewing a pending lawsuit by doctors against NCTracks. This section was removed at the request of DHHS officials, who argued it could be misinterpreted by viewers.


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