NC doctors sue state over Medicaid payment delays - WNCN: News, Weather

NC doctors sue state over Medicaid payment delays

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A group of doctors filed a class-action lawsuit seeking millions of dollars in damages over flawed computer programs that severely delayed Medicaid reimbursements. A group of doctors filed a class-action lawsuit seeking millions of dollars in damages over flawed computer programs that severely delayed Medicaid reimbursements.
RALEIGH, N.C. -

A group of North Carolina doctors filed a class-action lawsuit Thursday seeking millions of dollars in damages from the state and its contractors over flawed computer programs that severely delayed Medicaid reimbursements.

The lawsuit alleges that managers at the Department of Health and Human Services and its contractors Computer Sciences Corporation, Maximus Consulting Services and SLI Global Solutions were negligent in the launch of NCTracks. The $484 million computer system is intended to streamline the process of filing Medicaid claims and issuing payments.

The N.C. Medical Society, which represents about 12,500 physicians and physician assistants in the state, issued a statement saying that the organization strongly supports the lawsuit. The listed plaintiffs in the case are doctors from Wake, Cumberland, New Hanover, Nash, Halifax and Robeson counties.

As class-action, lawyers for the group say more than 70,000 medical providers in the state suffered harm and could be entitled to damages. The lawsuit says medical providers have been "shorted" about $500 million since the system went live July 1.

"NCTracks has inflicted real damage on Medicaid patients and providers across the State for the last seven months," said Robert W. Seligson, the Medical Society's chief executive officer. "We understand, from our own tireless efforts to help our members overcome the system defects, that legal action may be the only remaining option to remedy the harm to the Medicaid system and get NCTracks to function as advertised."

The complaint filed Thursday alleges the launch of NCTracks was a "disaster" and that the software was riddled with more than 3,200 errors. The problems led to delays of weeks and sometimes months before medical providers and hospitals received payment, forcing some businesses to take out loans to meet payroll. Some doctors say they were forced to stop treating Medicaid patients because of the delays.

"We're filing on behalf of health care providers, but we're also serving the low-income Medicaid recipients of North Carolina that rely on these providers to receive care," said Knicole Emanuel, one of the lawyers who filed the lawsuit. "Since these providers have experienced financial hardship due to NCTracks, many of them are no longer able to serve the state's most vulnerable population of health care consumers."

DHHS Chief Information Officer Joe Cooper, who oversees NCTracks, said he could not comment of on pending litigation. But he reiterated several of the talking points issued by the agency in recent months to suggest NCTracks is actually performing well.

"As with any implementation of an IT system of this size and complexity, the transition has not been without challenges," Cooper said, according to a statement issued by the agency. "To date, the new system has processed more than 104 million claims and paid more than $5.5 billion to North Carolina healthcare providers, out-performing the 35-year old system it replaced. DHHS continues to address provider issues as they arise, and will not rest until every provider is fully transitioned to the new system."

The state's doctors don't see NCTracks as an improvement. Seligson described the system as a "poorly tested, defective and very expensive software product."

"The resulting problems for the State of North Carolina and its citizens have no doubt been a huge challenge for the DHHS and required additional resources that the department was not expecting to incur," Seligson said. "So far none of us received what we were promised."

Home Again Senior Care in Monroe, N.C., had direct experience with NCTracks, saying it struggled with the system for about seven weeks.

"Implementation of it -- from my experience right off the bat -- was badly handled," said Chris Lonan with Home Again Senior Care. "Their help desk was swamped and overwhelmed, wait times were so long you couldn't get through and if you did [get through, you got a ticket number you'd never get a call back on."

To read the full lawsuit, click here.

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