Medicaid Information System Goes Live By Deadline, No Major Issues Expected

CARSON CITY – A state official said today the firm hired in January to take over the operation of the Medicaid billing and information systems has completed its work by today’s deadline.

HP Enterprise Services was given a four-month extension to complete the transfer and start-up of the system after it failed to make an Aug. 1 deadline.

Today, Charles Duarte, administrator of the state Division of Health Care Financing and Policy, which oversees the Medicaid program, said the transfer was completed by the new deadline.

“We’re on schedule,” he said.

The firm started up a new piece of the system, the pharmacy claims system, on Friday, he said.

Photo courtesy of User.Oaktree_b via Wikimedia Commons.

“There were a few issues over the weekend but nothing major,” Duarte said.

Some of the national pharmacy chains had to send the software to their local stores, he said.

The main piece of the system, the Medicaid Management Information System, went live Sunday at 11:30 p.m., Duarte said.

“All our call centers are operating,” he said. “So everything is moving along.

“A big test will be when we actually adjudicate those claims tonight, both electronic and paper claims, to see what kind of performance we get out of the system tomorrow,” Duarte said. “But we’re very optimistic that things will process well this evening.”

The testing of the system in parallel with the old system worked out very well, he said. There will probably be a few glitches, but nothing major, Duarte said.

The Nevada News Bureau first reported in October that the contractor, hired in January to operate the system for $177 million over five years, had missed its Aug. 1 deadline.

Duarte said today that the Nevada Department of Health and Human Services will enter into discussions with HP Enterprise Services regarding the missed deadline now that the transfer has been completed. The state does have the ability to seek damages for a failure of the company to deliver on the terms of the contract, he said in October.

“Because of the need to focus on getting the system operational, get it standing up, we moved off that and are going to reengage them in that discussion again,” Duarte said. “So once all systems are green and everything is working well it’s going to be time to sit down and talk about the contract.”

The HP contract was approved by the Board of Examiners, including Gov. Brian Sandoval, in January, but not without controversy. The second lowest bidder, ACS, raised numerous concerns about the negotiations that resulted in HP winning the contract, including $30 million in additional value that brought the cost of the HP bid close to that of ACS. The company did not formally challenge the award, however, because of the costs involved.

The Medicaid information system is critically important to Nevada and the U.S. Department of Health and Human Services, which share in the costs of delivering medical services to the approximately 300,000 low-income Nevada recipients, typically families, seniors and the disabled.

Once the system is certified by the federal Centers for Medicare & Medicaid Services next year, the state expects to see enhanced federal reimbursements for the Medicaid program, he said.

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Audio clips:

Charles Duarte, administrator of the state Division of Health Care Financing and Policy, which oversees the Medicaid program, says the main part of the system went live Sunday at 11:30 p.m.:

120511Duarte1 :24 is moving along.”

Duarte says a big test will come tomorrow after the claims are processed this evening:

120511Duarte2 :17 well this evening.”

Duarte says the state will discuss the contract and delay with HP now that the system is functional:

120511Duarte3 :15 about the contract.”

 

  • Disgusted

    What a joke.  Duarte says “there were a few problems over the weekend”…they’ve transposed provider numbers so as to send conflicting information on their remittance advice;  try to call customer service and you wait at least an hour, then when someone answers they don’t know enough to be able to help you.  This is typical for any operation lead by Duarte…what a know nothing clown…just good buddies with Willden so he has nothing to worry about.   Nevada’s tax dollars hard at work. 

  • Charles Duarte

    Dear Disgusted,

    If you have a specific issue, please feel free to call my office.  I would be glad to discuss your concerns.  While there were some start up issues they are getting resolved.  My number is 775-684-3677.

    Sincerely,

    Charles Duarte, Administrator
    Division of Health Care Financing and Policy

  • TaxPayer

    As a provider trying to obtain eligibility information, this new system is a nightmare.
     
    Mr. Duarte, instead of wasting my tax dollars responding to blogs while you are at work on my dime, how about fixing the system you have touted so publicly for those of us actually trying to get something done during the work day?

  • AlsoDisgusted

    Mr Duarte,
    Of course you need to seek damages from HP for failure to do what they agreed to do according to a written, signed , legal document. IT IS NOT YOUR MONEY, IT IS MINE, the taxpayer.  And stop testifying at the legislature that the millions of dollars in overpayments are a drop in Medicaid’s budget while I , as your emplyee, am on furlough. Because guess what? It’s not your money, it is mine, the tax payer.