Obamacare 'Back End' Contractor Also Runs Troubled Medicare Website

    As the October 1 launch of Healthcare.gov drew closer, the Centers for Medicare and Medicaid Services (CMS) realized it was in trouble.  The agency, which is the primary Health and Human Services (HHS) department in charge of the implementation of the Affordable Care Act, decided in early August that the "specialized financial management services and expertise [needed were] beyond what was initially anticipated and beyond CMS' currently available resources," and that development and testing were "already minimally two months overdue."  By that time, the need for these so-called "back end" services had "reached an unusual and compelling level of urgency," and CMS awarded an emergency, no-bid contract for the work, as first reported by THE WEEKLY STANDARD in September.  After HHS initially responded with a promise of more information, the agency has ignored repeated requests for further details.  Reuters was stonewalled by the agency as well in a November story about the contract.

    To avoid the "severe consequences" that CMS feared would result from further delay, the agency turned to a current HHS contractor, Novitas Solutions, a wholly-owned subsidiary of Diversified Service Options, which is in turn a wholly-owned subsidiary of Florida Blue (Blue Cross/Blue Shield of Florida.)  Novitas already administers three different Medicare-related healthcare programs for HHS, including the Medicare Administrative Contract for Jurisdiction H, which covers seven south-central states.
    Coincidentally, Novitas launched a new website for Jurisdiction H on September 29, just two days before the launch of the main Obamacare site.  The new Jurisdiction H website has experienced problems reminiscent of those experienced by Healthcare.gov, and some of the "fixes" will not be in place until well into 2014.  In fact, the latest update from Novitas informed users that the Jurisdiction H website would be taken offline completely at 7 PM on Wednesday, December 18, for up to five hours for maintenance.
    A report on the website of the Oklahoma Hospital Association (OHA) on December 4 gave some details of the issues facing users of the troubled Novitas Medicare site:

Hospitals continue to experience problems stemming from system changes at Novitas Solutions, the Medicare Administrative Contractor (MAC) for Oklahoma and other south central states. 

Novitas launched a new website on Sep. 29. This was the most visible change stemming from the transfer of Novitas’ business operations platform from the data center of its former owner, Highmark, to that of Blue Cross and Blue Shield of Florida. 

As an example of the website problems, Novitas intended to display content for Part A and Part B separately. This is not working as planned. A manual process of splitting all website content is underway, with a completion goal of February 2014. 

While some of the website problems are apparent to users, more serious problems remain to be resolved behind the scenes in the MAC’s workflow management. David Vaughan, Jurisdiction H project manager for Novitas, told OHA that the system changeover caused a delay of a week or so during which Novitas was unable to use its imaging system. This created backlogs in processing documentation related to medical reviews and appeals. Although the backlog has been reduced, the problems have not been fully resolved.

    Unlike the government has done with Healthcare.gov, however, Novitas maintains a detailed  webpage listing the ongoing issues with the Jurisdiction H site.  The page asks users to "[p]lease pardon our dust as we continue to squash bugs and implement improvements on our new internet site." More than a dozen problems are listed as unresolved as late as Thursday, December 11, the last time the page was updated.  The issues range from web pages not loading properly to duplicate enrollment determination letters to long wait times for customer service.  Another item noted is the planned Interactive Fee Schedule Calculator which is still unavailable.  The status of that issue indicates that "[r]esolution of issues encountered since 9/30/13 is expected by mid-January" 2014.
    When asked for comment on the December 4 Oklahoma Hospital Association report, a spokesperson for Diversified Service Options, Novitas's parent company, wrote:

It is not a news story but an association update, so I have no comment on the Novitas website operation facts as they are stated. As mentioned by OHA, Novitas has been very transparent and proactive with providers, and listed the status of the operational problems.

    Inquiries to HHS/CMS about the Jurisdiction H website, as well as the original emergency, no-bid contract with Novitas for Obamacare-related financial services, continue to go unanswered.


Note: A version of this article first appeared at The Weekly Standard.