One message came through loud and clear at today’s meeting of the Washington Health Benefit Exchange’s Operations Committee: It may not be time to panic about the health exchange’s problem-riddled invoicing and payments system, but it is time to sound the alarm and get all hands on deck.
“We are really out of rope on this one,” Chief of Staff Pam MacEwan told the committee. “We need this to be fixed a while ago. We don’t have the patience of the public or the carriers on this anymore.”
Software problems have prevented payments for up to 6,000 consumer accounts from posting properly and being reported to insurers, resulting in some consumers being told they don’t have coverage.
Beth Walter, operations director, noted the exchange had received a commitment from Deloitte, the exchange’s primary contractor, to “engage additional resources on their side.”
“What does that mean?” asked a committee member.
“More people,” Walter replied.
“Good,” replied Melanie Curtice, committee chair. “A lot more people? We need as many as we can get. We’ve got to get every able-bodied person they can put on this on this now.”
Another committee member questioned Deloitte’s responsibility for the problems. “Do we need more people who don’t know what they’re doing to cost more money?” he asked. “When we contracted with them was this for a deliverable? Or are we paying now for something they said they were going to do and haven’t delivered.
“It’s their responsibility get this right and if there are defects it’s their responsibility to fix it,” MacEwan replied.
Brian Peyton, director of legal services, agreed. “The contract requires that they deliver the system that they did, which included a billing and payment module, and that they, as part of their warranty and operation and maintenance of the system, correct defects.”
The committee also noted that the staff was exploring whether invoicing and payments should be handled by the insurers or contracted out to a third party.
MacEwan, however, noted there are fundamental problems to be solved.
“There are some underlying data issues that must be resolved under any scenario,” she warned. “We couldn’t go forward with a relationship with another entity with the kind of data problems we are having because it would solve nothing.”
After the data problems are fixed, she said, “then we can make a determination of whether it’s best for us to do it, best for the carriers to do some or all of it or whether would be best to work with a third-party administrator.”