The state and its contractor have struggled to correct issues with the Unified Health Infrastructure Project since the system launched in 2016.
(TNS) — PROVIDENCE, R.I. — As a direct result of the $492-million UHIP debacle, the state has been unable to apply for a federal match on more than $100 million in Medicaid payments that the Raimondo administration advanced over the last year and a half to nursing homes and other long-term care providers, according to a key lawmaker.
"We are bleeding this money out of the general fund," said House Oversight Committee Chairwoman Patricia Serpa.
"That's money that we could be dedicating to the budget that we're going to be voting on in June ... [to help avert] the cuts that the governor has proposed to the hospitals, to the developmentally disabled, to the people receiving home-care services," she said.
Serpa raised the concern on Thursday, on the day that representatives of Deloitte Consulting came to the State House to apologize for all of the problems the state has faced since launching the Deloitte-designed Unified Health Infrastructure Project, known as UHIP, in September 2016 to "streamline" eligibility verification for food stamps, Medicaid, subsidized child care and cash assistance.
Under-payments. Over-payments. Long lines at field offices. And application-processing backlogs for Food Stamps so high at one point, the ACLU sued.
"On behalf of Deloitte, we want to apologize to you and to the people of Rhode Island," said Deborah Sills, the national managing principal for the public-sector arm of Deloitte's business.
"We are very sorry for the impact that our system issues have had on your constituents, on state workers and on service providers,'' she told the Oversight Committee. "While the technology is working much better than it was, we still have work to do. We know there are still some people having difficulty accessing benefits, processing cases or receiving timely payments.
"We will not let up until we have made things right,'' she said. By her estimate, Deloitte has been paid close to $240 million for its working on the two-phase project, credited some of that back and agreed not to bill the state close to $87 million overall.
As to why so many things went wrong, Sills said: "Simply put, the system is very complex ... the only eligibility system in the country that integrates more than 10 state and federal health and human services programs and a state based health insurance exchange ... As the state's comprehensive analysis last year made clear, Deloitte and the state needed 'more time, more people and more training.'"
Over the next two hours, lawmakers grilled Sills and her colleague, Kenny Smith, repeatedly on whether the Raimondo administration made a mistake when it flipped the switch, without the "live pilot'' urged by the federal government.
"With the best information we had at the time, both the state and us together felt the system was ready to go into production,'' Sills said. "If we were making the decision with the information we [have] today, in retrospect, it would have been a very good idea for us to go to pilot and have the opportunity to find some of the problems that didn't present themselves'' until later.
Asked if the trouble-prone system will ever be fully functional "with no backlogs,'' Smith said: "The system is working well for many, many Rhode Islanders and many of the programs ... We have data that shows us that we are moving absolutely in the right direction across all of the programs ... It is normal that states carry some backlogs.... There is never a time where there is none.''
"So there is no definitive date on when the system will be fixed, when the backlog is at a level that's typically seen in other states?" asked Rep. Joseph Solomon. Smith said he is confident the system will meet the state's needs, but "I can't comment on a date at which it's going to be acceptable."
Earlier in the day, Serpa questioned the state's ability to recoup any portion of the $100-million plus advanced to the nursing homes. Auditor General Dennis Hoyle said the math goes like this: the state has, over the last 21 months, made about $130 million in advance Medicaid payments to nursing homes and other providers, for patients snagged in UHIP's application backlogs.
The federal government normally reimburses the state for about 51 percent of that spending, but only a small portion has been reimbursed by the federal government so far: about $12.5 million.
Hoyle said the other $100 million is "potentially eligible for reimbursement [at the federal matching rate] but they haven't drawn any federal funds — or claimed that yet — because eligibility hasn't been fully determined and reconciled back to the advances that were made."
While Serpa said she has been told that could take up to two years, Ashley G. O'Shea, the spokeswoman for the Executive Office of Health & Human Services, said:
"The State has plans in place to ensure that we will receive matching federal funds for the contingency payments cited in the Auditor General's report ... We have already recovered more than $1 million in over payments from three nursing homes and continue to make progress clearing the backlog of applications."
But Serpa said some nursing home administrators have told her privately that they have been overpaid. "I don't think that the federal government is responsible for reimbursing us for any over payments we made."
"I'm very, very worried," she said. "I feel like we are doing a dance around a big fire. This is a failure of Biblical proportions, and I don't think that is hyperbole."
©2018 The Providence Journal (Providence, R.I.) Distributed by Tribune Content Agency, LLC.