Complaint filed with FTC over Deloitte's Medicaid eligibility software

A software Texas uses to process Medicaid renewals is not working accurately, causing people to be wrongfully disenrolled from the program, advocates allege. 

The National Health Law Program submitted a complaint to the Federal Trade Commission Jan. 31, asking the agency to investigate Texas's automatic eligibility software, operated by Deloitte. 

The advising firm provides Medicaid eligibility software in at least 20 states, according to the National Health Law Program. In August, staff working with the state's software wrote to the Texas Health and Human Services Commissioner, expressing concerns that system errors were causing individuals to be erroneously disenrolled. 

In a Jan. 31 news release, Sarah Grusin, a senior attorney at the National Health Law Program, alleged Deloitte was aware of numerous errors in eligibility software in the last decade. 

"These flaws lead to people who are eligible for Medicaid losing coverage because of design and programming errors made by Deloitte," Ms. Grusin said. 

The advocacy group asked the FTC to pause the use of Deloitte's software and require the creation of a risk mitigation strategy to prevent wrongful terminations of Medicaid coverage in Texas. 

A spokesperson for Deloittee told Becker's the company believes the complaint is without merit. 

"Deloitte collaborates with hundreds of government agencies throughout the country and is deeply committed to positively impacting the people they serve," the spokesperson said. "The innovative technology systems we help states develop and maintain provide health and human services benefits to millions of families every day. In all states, we work at the direction of our clients to implement state-specific policies, rules and processes." 

According to KFF, Texas has disenrolled 1.8 million Medicaid beneficiaries since June 2023, the most of any state. Of those disenrolled, 67% had their coverage terminated for procedural reasons, rather than being determined no longer eligible for the program on the basis of income. 

In April 2023, states began the process of determining Medicaid recipients' eligibility for the program for the first time since continuous coverage requirements went into effect during the COVID-19 pandemic. 

CMS has warned states that automatic renewal systems can result in wrongful terminations of Medicaid coverage. In September, the agency paused procedural terminations in 30 states and reinstated coverage for more than 50,000 people incorrectly disenrolled through what CMS called a "glitch." 

A spokesperson for the Texas Health and Human Services Commission told Becker's the agency is aware of the complaint and "will continue to implement strategies to ensure the redetermination process operates as smoothly as possible for our clients." 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Top 40 articles from the past 6 months