|
 The error rate has improved since HealthCare.gov's disastrous
debut on October 1, which created a political crisis for Obama as
opponents and supporters of the law questioned whether the most
sweeping social program since the 1960s was rushed well before it
was ready.
Last week, the White House wrapped up a five-week emergency effort
to fix the most obvious of the website's technical problems and
between midnight on Sunday and noon on Friday, government health
officials said 3.7 million people visited.
But the current level of mistakes deeper into the system are
creating a new workload for insurers to verify the details of their
new members and could lead to unwelcome surprises for consumers if
there are mistakes in new policies that take effect on January 1.
HealthCare.gov relays information about new customers in so-called
"834" transaction forms to the private insurance companies that
provide the health plans. The portal serves people in 36 states
while 14 states are running their own online marketplaces.
"We believe nine of 10 transactions are being successfully
transmitted," the Centers for Medicare and Medicaid Services, or
CMS, spokeswoman Julie Bataille said at a news briefing.
Previously, Bataille has said the majority of errors had been fixed
in these transactions but had not defined either the current or past
rate of mistakes.
She said the error rate has fallen, explaining that in the more than
two months since October 1, HealthCare.gov could have experienced an
error in as many as one in four transactions. Errors include forms
not being generated, transmitting duplicate forms and of forms with
technical data being passed incorrectly, she said.
Widespread errors in coverage could add to public complaints over
the law's rollout and provide ammunition to Republican lawmakers who
have campaigned all along to delay or replace the 2010 Affordable
Care Act, commonly known as Obamacare.
"The new process put in place this week is making a difference. The
enrollment files are getting better, but there is more work to do to
ensure consumers are covered," Karen Ignani, the chief
executive officer of insurance industry trade group, America's Health Insurance
Plans, said in a statement on Friday. BACKUP
SYSTEM
Insurers are also working with CMS on testing a short-term backup
system for the government to pay insurers for the income-based
subsidies that many individuals will qualify for on the new online
exchanges. The permanent system was not built before the website
opened for enrollment.
[to top of second column] |
The glitch-ridden consumer end of the website held back enrollment
during October, when fewer than 27,000 people enrolled through
HealthCare.gov. The government set a November 30 deadline for
repairs. On Sunday and Monday alone, 29,000 people signed up,
sources familiar with the number said.
The enrollment growth has raised questions about how insurers will
keep up if the applications have errors and whether consumers will
think they are covered by an insurance policy when they are not.
For instance, Jason Alford, the director of individual and
marketplace sales at Health First Health Plans in Rockledge,
Florida, said in an interview this week that applications are still
incorrectly displaying if the person is a smoker or a non-smoker, a
factor that determines the premium price in the state.
CMS said that there is a technology team dedicated to fixing the
issues with the transaction forms. The team is overseen by the
general contractor on the project QSSI, a unit of UnitedHealth Group
Inc.
In an unusual show of solidarity, AHIP, CMS and the Blue Cross Blue
Shield Association — whose licensees are the largest players on the
insurance exchanges — this week issued a joint statement to stress
their efforts to fix "back end" problems on HealthCare.gov.
Daniel Durham, vice president for policy and regulatory affairs at
AHIP, said this week that insurers will estimate how much they are
owed, and submit that estimate to the government.
Once the permanent system is built, the government and insurers can
reconcile the payments made with the plan data to "true up"
payments, he said.
(Reporting by Caroline Humer in New York, David Morgan and Roberta
Rampton in Washington; editing by Michele Gershberg and Grant
McCool)
[© 2013 Thomson Reuters. All rights
reserved.] Copyright 2013 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
