Healthcare Technology Featured Article

October 13, 2014

Vermont Health Connect to Undergo Audit


States around the country are gearing up for round two of the Affordable Care Act enrollment next month, and considering the monumental fiasco that took place last year, officials around the country are making sure this time around everything goes according to plan. However, this is a government initiative and if any past experiences have taught us anything, it is public organizations find ways to mess up what private companies do so well every day. Vermont’s Health Connect, the state’s health insurance marketplace, has announced it will conduct a comprehensive audit to ensure everything is working before the open enrollment period begins on November 15.

According to the Washington Post, 30 to 40 million people still remain uninsured in the United States and experts believe this particular group is going to be harder to enroll than the first batch of eager participants who wanted health insurance.

The Vermont Health Connect experienced the same glitches as many other states, including its website, call centers, security and management issues. The goal for this new audit is to test the performance of every contact point customers will have with Health Connect and fix all of its problems.

State officials have indicated the program integrity audit is required by the federal government, and the Agency of Human Services started the search for a contractor to perform the audit late last month. The state has to be compliant with federal rules governing the programs such as Medicaid and Medicare services in order to ensure its insurance exchange is able to accurately determine benefit levels for low income customers.

State Auditor Doug Hoffer said in August of this year, “These things are complicated and take a long time. I have yet to see an audit take less than four months — six is more likely,” Hoffer said. “It’s my intention to really encourage folks to find a way to get this done during the [legislative] session. That might involve trimming the objectives to save time.”

The audit will begin Jan. 3, and its findings are due by the middle of March.

Vermont has spent more than $70 million on the exchange so far, and while state officials are not in complete agreement as to how long the audit will take, they won’t get the results long after the November 15 date of the new rounds of enrollment. It begs the question, why didn’t the state conduct the audit before the new enrollment period?




Edited by Maurice Nagle





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