The ASC X12 834 benefit enrollment and maintenance transaction, which was developed by the Accredited Standards Committee of the American National Standards Institute, has not been uniformly implemented. It's been a source of some difficulty in communication between the federal exchange and insurers in the 36 states where the federal government is running the exchanges.
The Wednesday afternoon meeting was part of the “tech surge” the Obama administration announced earlier this week. The effort has included bringing in outside expertise and tech talent to help fix the federal exchange website, HealthCare.gov, which launched Oct. 1 with terrible results so far. Many visitors have had extreme difficulty getting plan and rate information, opening an account, and signing up for coverage. In addition, insurers report receiving inaccurate and incomplete information from the federal site.
On Monday, in a televised address, Obama acknowledged the problems, saying, “The website is too slow and people are getting stuck. Nobody's madder than me about the website not working as it should, which means, it's going to get fixed.”
According to the White House, the Obama administration and the participating insurers have established “alpha teams,” which are “made up of insurers' technology experts and CMS technology experts, to iron out kinks in both the 834 forms and in direct enrollment. These teams are “meeting virtually” with the CMS and the government's prime contractor on the project, CGI Federal, the U.S. subsidiary of the Canadian technology firm, CGI Group, and working to correct problems “as soon as we see them.”
Other healthcare industry leaders participating in Wednesday's meeting were: Patrick Geraghty, CEO of Blue Cross and Blue Shield of Florida; Jay Gellert, president and CEO of Health Net; Patricia Hemingway Hall, president and CEO of Health Care Services Corp.; Daniel Hilferty, president and CEO of Independence Blue Cross; Karen Ignagni, president and CEO of the trade group America's Health Insurance Plans; John Molina, chief financial officer of Molina Healthcare; Michael Neidorff, chairman and CEO of Centene Corp.; James Roosevelt Jr., president and CEO of Tufts Health Plan Foundation; and Scott Serota, president and CEO of the Blue Cross and Blue Shield Association.
The administration announced that Jeffrey Zients will be coming onboard to provide management advice to HHS on the insurance exchange project. Zients formerly served the Obama administration as deputy budget director in the White House's Office of Management and Budget and served as a troubleshooter on the Cash for Clunkers program under the federal economic stimulus law in 2009. He is slated to take over as director of the president's National Economic Council Jan. 1.
At a news conference Tuesday, White House spokesman Jay Carney responded to a question about service problems attributed to the batting order of functions on the federal website compared with some smoother running state exchanges, like Kentucky's, which allow a person to shop for health plans early in the process before shifting a user to the federal site with its more elaborate and more bandwidth-hogging functions that require encryption, such as identify proofing and income verification.
Carney said that beginning this past Monday, the federal website also was equipped with a shopping feature that allowed consumers who visit the website to type in their ZIP code and “comparison-shop and begin to make decisions” about their health plans.
The federal site had required a user to open an “account” first by providing individually identifiable information such as name and date of birth before they were allowed to shop for plans.
Carney also ducked a question about when or whether Chief Technology Officer Todd Park or White House Chief Information Officer Steve VanRoekel were aware of the problems with HealthCare.gov. Park, a co-founder of Athenahealth, a developer of Web-based practice management and electronic health-record systems for office-based physicians, joined the Obama administration in 2009 and served more than two years as chief technology officer at HHS before being named White House CTO in March 2012.
On Tuesday, Republicans on the House Oversight and Government Reform Committee sent a letter to Park and VanRoekel, saying “we are concerned that the administration required contractors to change course late in the implementation process to conceal Obamacare's effect on increasing health insurance premiums,” the letter said.
“We believe that the political decision to mask the 'sticker shock' of Obamacare to the American people prevented contractors from using universally accepted and OMB-advocated IT 'best practices' in the development and rollout of this massive federal government IT project,” the letter said.
The House Oversight and Government Reform Committee today sent letters to five technology companies—Verizon Enterprise, Google, Microsoft Corp., Oracle and Expedia—asking if they've been asked to participate or have been engaged in the tech surge and inquiring about the procurement process.
While the federal exchange has struggled, several state-run exchanges are reporting relative success in enrolling consumers in private health plans and Medicaid, including Kentucky, Minnesota and New York.
State health officials in New York Wednesday said its exchange, NY State of Health, has received nearly 174,000 applications and 37,030 New Yorkers have enrolled in coverage.
“Our marketplace is operating very smoothly, and we are pleased to see that tens of thousands of individuals and small business owners across the state are turning to (it) to access low-cost health insurance,” said Donna Frescatore, the exchange's executive director said in a news release.
Follow Joseph Conn on Twitter: @MHJConn
