Report Unable to Identify Key Decision-Makers in Health Exchange Development

Legislative auditors acknowledged the review "was not conducted in accordance with generally accepted government auditing standards."

by Bethany Rodgers, McClatchy News Service / April 4, 2014

State legislators Thursday grilled leaders of Maryland’s health insurance marketplace shortly after the release of a report that did not determine who was responsible for key decisions during development of the exchange’s glitchy website.

The report prepared by the Maryland Office of Legislative Audits reviewed concerns raised during construction of the problematic website. However, the legislative auditors acknowledged the limitations of their report, writing in an accompanying letter that the “review was not conducted in accordance with generally accepted government auditing standards.”

The auditors did not interview stakeholders or individuals involved in the project and based their conclusions on documents that they did not check for accuracy or completeness.

Evaluating major components of the project was impossible because of heavy redactions or lack of information, the auditors reported. For instance, the available records did not afford a clear picture of the management system in place during the exchange’s development, and auditors were unable to determine who was responsible for certain decisions.

“We don’t have a complete story,” said Thomas Barnickel, legislative auditor. “There’s more information in the media sources than that is in here.”

As a committee of legislators reviewed the report, Sen. David Brinkley focused on the gaps in information, asking Barnickel whether he could comment on the state’s procurement process when hiring vendors to develop the website. But lacking the necessary information, the auditors were unable to determine the propriety of the state’s contracting process, Barnickel said.

Barnickel said his group simply executed the charge given to them by the Joint Oversight Committee on the Maryland Health Benefit Exchange, which tasked the auditors to review and distill an array of publicly available documents.

His agency will have access to more comprehensive information when it conducts a performance audit, set to begin this summer, he said. The federal government will also conduct an audit of Maryland’s health exchange.

In developing Thursday’s review, the legislative auditors relied heavily on reports prepared by BerryDunn, a consultant hired to monitor the development of the health exchange system.

The BerryDunn reports flagged potential risks related to website security and lack of performance testing before its launch Oct. 1. The website design was another area of concern in the months before the exchange rollout, according to the audit.

In one report, “BerryDunn indicated that the specific functionality that the state could expect at the October 1, 2013 go-live date was unclear,” the legislative report stated.

Joshua Sharfstein, the state’s secretary of health and mental hygiene, also briefed the joint oversight committee Thursday and reviewed efforts to upgrade the exchange technology with a platform used in Connecticut.

Moving to Connecticut’s system is estimated to cost between $40 million and $50 million, and Brinkley asked Sharfstein about the ultimate price tag for the health exchange. Sharfstein said he didn’t have the figures on hand, but Brinkley said by his estimate, they could approach $300 million through fiscal 2015.

“We’re talking staggering numbers here, not just big numbers,” said Brinkley, R-District 4, who sits on the joint oversight committee.

Sharfstein noted that the exchange encompasses far more than the website and includes staff, call centers, training and advertising.

©2014 The Frederick News-Post (Frederick, Md.)