Complaints roll in about N.C. Medicaid claims system

Officials at the North Carolina Department of Health and Human Services issued public statements last summer saying the new computer system for processing Medicaid claims was working great, even as newly released records show complaints were coming from across the state.

The News & Observer of Raleigh reported Friday that letters poured into the office of Gov. Pat McCrory last summer from frustrated medical providers who were not getting paid following the July 1 launch of the NCTRACKS program.

Records show one of McCrory's constituent services representatives, Jeff Moore, sent DHHS spokesman Ricky Diaz an assessment in a July 22 email from Moore's father, an orthopedic surgeon in Carteret County.

"The new 'NCTracks', which is the admin system for Medicaid, is pretty much a disaster. True to form, the person in charge says it is working pretty well. All the doctors' offices in Carteret County have been without Medicaid payments since it rolled out the first of this month. The system listed me as a provider of fertility services, so when my claims were sent for orthopedic surgery, they were denied."

Despite the firsthand accounts indicating widespread problems, Diaz issued a news release Aug. 5 titled "NCTRACKS is On Track" that sought to reassure the public that new $484 million computer system was working well.

Although the statement conceded there may be some glitches, the agency said it was on top of the issues. The only medical provider whose experience was featured in the agency's sunny release was quoted as saying "The system is great!"

Diaz also sent talking points to McCrory's staff that mirrored the agency's statements of success.

"Keep driving home the point that we're being proactive in helping providers," Diaz wrote July 25. "System is working, it's paying and processing claims. We're committed to helping them transition."

In response to questions Thursday, Diaz emailed a statement to The N&O that mirrored his earlier talking points, saying the agency has put "all available resources toward proactively reaching out to providers ... to assist them with this monumental transition."

The system has processed tens of millions of claims and paid $2.2 billion to health care providers since July 1, Diaz wrote. However, the agency has provided no public information on the numbers of claims that have been delayed or gone unpaid.

State legislators, many of whom have been receiving frequent constituent complaints about NCTRACKS, have scheduled an all-day oversight hearing for Oct. 8 to collect information about the computer problems and other issues at the embattled state health agency.