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Connecticut Coding Issues Not Expected to Affect Maryland Health Exchange

Maryland officials have been preparing to use the technology underlying the Connecticut exchange, and still expect the new website to be operating smoothly in November

Coding problems that led to coverage and billing troubles for thousands of consumers using Connecticut's online insurance marketplace will be fixed in Maryland's version of the technology, officials said today.

Maryland officials had been preparing to use the technology underlying the Connecticut exchange after ditching their own glitch-prone software. They still expect the new Maryland Health Benefit Exchange website to be operating smoothly in November, when the next round of consumers will be allowed to buy health coverage. 

"We remain on schedule," Isabel FitzGerald, the state secretary of information technology, tapped to oversee development of the new website, told the exchange board this afternoon.

Earlier in the day, she told a legislative oversight panel about the coding issue: "We are aware of it. It will be corrected in our version … before the 'go-live' for us."

Connecticut exchange officials reported recently that about 5,000 people had been enrolled inadvertently in Medicaid, had lost their subsidies or had their coverage dropped. All suffered problems after reporting a change in their life or work status.

FitzGerald said the subsidy issue in the code was fixed before the technology was given to Maryland in May, and the other problems are expected to be rectified in the state's version by July 25. When the coding issue was found, the exchange had been in the process of modifying the software to use Maryland's logos and color scheme, as well as work with Maryland insurers and under state rules.

She also said the system continues to undergo testing, so any other problems should be discovered before open enrollment in the fall. A key test will come in August, with private insurance carriers offering policies on the exchange.

The state also has been working with federal regulators, who had to approve the move to the Connecticut technology, which was free but will cost $43 million to develop for use in Maryland.

And unlike the last rollout of the exchange website, which crashed on its first day in October, there will be multiple backup systems ready to go, such as manual work-arounds that exchange workers ultimately used to enroll people in insurance plans when the first website failed to work properly, FitzGerald said.

"I think we learned to fashion tools with objects around the campsite," said Dr. Joshua Sharfstein, state health secretary and chairman of the exchange board, after the board meeting. "We're a little battle-hardened. Though, these aren't things we expect to do."

During the afternoon meeting, board members also gave their marketing and communications firm, Weber Shandwick, an extra $3.5 million for outreach and marketing during the next open enrollment. That is on top of about $7.5 million already in the firm's contract but mostly spent.

Some lawmakers on the Joint Oversight Committee on the Maryland Health Benefit Exchange raised concerns earlier in the day about past marketing efforts for the website. They noted the botched rollout last year may make some consumers hesitant to try the exchange, and they also said enrollment seemed to be low in rural areas of the state.

"I didn't see a lot of promoting this effort," said state Sen. Edward J. Kasemeyer, a Democrat who represents Baltimore and Howard counties.

A public information request submitted by The Sun in January to detail how the money was used, and how effective the campaign was, has not been honored by the exchange. Officials have said they were inundated with information requests.

Sharfstein said future marketing efforts will need to focus on the success stories of patients who — even though they may have struggled with the website — are happy to finally have insurance they needed.

Carolyn Quattrocki, the exchange director, said the exchange will develop a marketing plan that promotes the need for health insurance and hits social media and in-person enrollment fairs, in addition to traditional advertising.

"We do have to communicate very effectively that this is an upgraded website. It is a new experience. … We need to win people back, if you will," Quattrocki said.

On Tuesday, Quattrocki was given a $20,000 salary boost to about $160,000. Her predecessor, Rebecca Pearce, who resigned under pressure after the last exchange site failed, earned about $199,500.

Exchange officials won't say yet what their enrollment goal is for the next open enrollment period. So far, about 300,300 people signed up for Medicaid through the exchange, and about 72,000 signed up for private insurance plans.

To gauge consumer awareness and attitudes about the exchange, Weber Shandwick will conduct a telephone survey beginning in late July of 800 people, including those who have used the exchange and those who haven't.

Chuck Fitzgibbon, an executive vice president at the global public relations firm, told the panel that the firm would work to rebuild trust among people who had a bad experience or otherwise stayed away from the exchange because of bad publicity.

Meanwhile, Republican gubernatorial candidate Larry Hogan questioned Tuesday whether exchange officials were really making progress developing the site and asked why Lt. Gov. Anthony Brown wasn't present at either the legislative hearing or the board meeting, since he served as the state's point man on health-care reform.

"Anthony Brown is pegging his promotion to governor on the notion that he's learned from his mistakes on the rollout of the health exchange," said Hogan, who supports a move to the federal exchange and private marketplaces.

Jerid Kurtz, Lt. Gov. Anthony Brown's communications director, wrote in a statement: "Even though over 372,000 Marylanders have received health-care coverage from the Affordable Care Act, Larry Hogan and his Tea Party backers are rooting against Marylanders receiving preventative care like mammograms."

State auditors also will begin fiscal and performance audits of the health exchange's troubled rollout. Legislative auditor Tom Barnickel said a performance audit will review the decisions that led to last year's troubled launch, including contracting policies and project management issues.

Barnickel said he expects to find that some of the problems are being corrected by the switch to the Connecticut-based system. But he said there could be valuable lessons to be learned from the botched rollout that could apply to the exchange moving forward or to other state agencies.

The federal government also is auditing Maryland's program. That audit is expected to be completed in December.

©2014 The Baltimore Sun