Vermont Health Connect misses another deadline

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Vermont Health Connect misses another deadline

Sun, 06/08/2014 - 11:09pm -- tim

by Morgan True vtdigger.org Developers of Vermont Health Connect will miss a revised deadline for website functionality that allows users to make changes to their coverage, a state official said Friday. A revised contract with CGI, the tech firm that is building the state’s health care exchange website, set a May 21 deadline for the upgrade, then the date was pushed back to June 8. Now there is no deadline in place for the basic website functionality. Since the website was launched October 1, 2013, users have not been able to adjust their coverage for life events such as a divorce, marriage, birth or job loss. In insurance lingo, this is known as a “change of circumstance.”

The only way to correct a mistake or update one’s coverage to reflect any number of changes is to call the Vermont Health Connect call center. Then a state worker must manually make the changes, and that information must be sent to the third-party premium processor, the insurer and the IRS if the change affects someone’s premium tax credit.

Mark Larson, commissioner of the Department of Vermont Health AccessMark Larson, commissioner of the Department of Vermont Health Access.

At the time, Mark Larson, commissioner of the Department of Vermont Health Access, which is responsible for completing the site that launched last year, said June 8 was “a more reasonable date to get the project done and done well.”

Larson said Friday that Vermonters still won’t be able to make changes to their coverage online after the deadline passes on Sunday.

“We’ve made really good progress, and we believe we’re getting close,” he said.

Larson would not give a new date for the change of circumstance functionality. That part of the website is not working properly during testing, he said.

The commissioner would not discuss whether the state would seek to impose penalties on CGI for missed deadlines that were incorporated into the revised contract.

“Our focus remains on getting the work done, there’ll be a time and a place to answer that question,” he said, adding that the penalties can be assessed retroactively. Talking about contractual issues would be a distraction from getting the work done, Larson said.

This week Larson announced that the state would hire an additional contractor to help work through the backlog of Vermonters who need to make coverage changes. Sources familiar with the negotiations have said that company will be Optum, a subsidiary of United Health Care, the nation’s second-largest health insurance company.

The number of cases hovers between 8,000 and 10,000 with more requests for changes coming in as others are resolved. There are only 28,000 people using Vermont Health Connect to pay commercial premiums. Though there are 60,000 people with commercial insurance through the exchange, the rest are in the small group market.

The small group market was enrolled entirely by the carriers participating in the exchange and their changes are handled by the insurers. The state’s contract with CGI stipulates that small groups must be able to use the website by July 2.

Larson would not say if he expected small businesses to be able to use the Vermont Health Connect website by that date. The federal government has said it will allow Vermont carriers to continue to enroll small groups directly through the upcoming open enrollment period, which begins Nov. 15.

Larson said if the state wants to extend that option it would be “another conversation.” He would not speculate on whether that will be necessary.

The final step will be allowing Vermonters to renew their coverage through the website, Larson said. Currently, the website isn’t ready for renewals and if open enrollment were to start tomorrow, people in the individual market would have to start the process over.

Larson said Vermonters who are already on the exchange would be able renew their coverage, but would not say whether they will be able to do so online, or if the state is looking at contingencies.

Larson said his department needs to make sure its decisions on when to deploy missing functions are based on when they’re ready and not on external pressures. He said the pressure his department feels is to provide better services to Vermonters.

“I’m sure that there are people who want to politicize it, but our job is to make sure that we get this right,” he said.

Some states that chose to build their own exchanges have scrapped them, and are considering going with the federal healthcare.gov website or purchasing software from other states with well-functioning exchanges.

Larson said he is aware that other states have or are considering purchasing software from other states, but that is not an option Vermont has considered.

“I think it’s hard to say that anything should be off that table, but we would have to have an assessment that that is a better path to serve Vermonters and that that is a viable path for Vermonters,” he said.