Contractor hired to fix Healthcare.gov reportedly has history of problems

Accenture, the contractor fired to fix ongoing problems with the federal health exchange website, has been heavily criticized by some of its largest clients, including federal agencies, according to a published report. 
The Washington Post reports that the U.S. Postal Service Inspector General's Office recommended this past June that the agency consider terminating more than $200 million in contracts with Accenture. The recommendation cited an "absence of business ethics" by the firm, including a 2011 settlement with the Justice Department to resolve allegations of "kickbacks" and "bid-rigging" in federal contracts. Accenture, which paid $63 million to resolve the claims, denied the allegations. 
The Obama administration announced last month that it had tapped Accenture to become the lead contractor for Healthcare.gov after cutting ties with CGI Federal, which handled the site's troubled launch this past Oct. 1. Technical glitches blocked many prospective customers from initially using the site, and while enrollment has picked up, the numbers have struggled to recover from the early setback and reach the administration's benchmarks. 
Accenture's contract to oversee Healthcare.gov is believed to be for one year and worth an estimated $91 million. Experts interviewed by the Post were divided over whether Accenture was the right choice to tackle the ongoing problems of the site, with one IT consulting firm executive saying Accenture was "at the top of the stack" in the industry. However, the same executive also questioned whether Accenture's relative lack of experience in health care would be an issue. Citing the government spending tracker website USASpending.gov, the Post reported that less than $50 million of Accenture's $10 billion in federal contracts has involved the Centers for Medicare and Medicaid Services. 
The Post reports that nearly 30 projects undertaken by Accenture over the past 10 years have encountered problems like technical malfunctions and cost overruns. Among the troublesome federal projects spotlighted by the Post include a computer system for the Department of the Interior's Mineral Management Service, which regulates the oil industry. A 2007 report  quoted an accounted as telling auditors that the system took longer to use than the one it replaced. 
Between 2004 and 2007, the Post reports that the Pentagon and four states canceled Accenture contracts to develop online voting for voter registration systems. And in 2006, a report by the IT firm The Wendell Group blasted a tax office computer system for the District of Columbia developed by Accenture. The report found that the system incorrectly calculated penalties and interest on tax bills and called it "poorly designed" and "mismanaged."
"There is a real concern," Daniel I Gordon, the former head of government procurement policy for the Obama administration, told the Post. "This company has problems in their past performance that are relevant and recent ... The real question is whether the government did its due diligence."

Vets face crashes, delays on fed's online benefits system like those that plagued ObamaCare site

The glitches and other problems with the ObamaCare website that sparked a national firestorm are similar to those military veterans using the federal government’s online benefits system have routinely faced for about the past 18 months.
Eric Jenkins, a veteran and American Federation of Government Employees representative, recently told Congress that during January, the Veterans Benefits Management System crashed about once a week, with downtimes ranging from one hour to multiple days.
“The constant … technical issues and frequent shutdowns make it difficult for me and others to serve veterans,” Jenkins told a House Veterans Affairs subcommittee.
The $537 million system went online in fall 2012 at a Department of Veteran Affairs office in New England and is now in all 56 regional offices.
The change to a paperless system was a major part of the Veterans Affair’s goal of eliminating a massive backlog of compensation claims by 2015 with 98 percent accuracy.
The number of claims started skyrocketed in 2010, to more than 1 million annually, in large part because of troops returning from Iraq and Afghanistan.
But Jenkins and other critics say the push to slash the backlog has created its own problems, similar to those experienced by insurance shoppers on the ObamaCare website, HealthCare.gov.
Jenkins said the VA computer system had to be rebooted four times during one week, resulting in him losing all the electronic claims on which he was working, with no paper documents as backup.
The problem is “quantity over quality,” he said in testimony Wednesday before the Subcommittee on Disability Assistance and Memorial Affairs.
The federal ObamaCare website and the 14 state-run exchanges went online in October, but their early debut also was spoiled by crashes, as well as slow response times and the dissemination of inaccurate information.
Jenkins, a disabled combat veteran and a VA service representative,  also pointed out that the benefits management system has another problems similar to one during the rollout of ObamaCare -- more users compound slow response times.
Subcommittee Chairman John Runyan, R-Pa., said the regular, weekly shutdowns “weren’t the only problems” with Veterans Affairs systems, pointing to a recent security breach of the electronic benefits system that reportedly compromised the personal data of 1,400  users.
“The lack of security is of tremendous concern,” he said.
Nevada Rep. Dina Titus, the subcommittee’s top ranking Democrat, said: “We’re not overly impressed by the systems’ security and consistency.”

Exclusive: AIDS patients in Obamacare limbo as insurers reject checks

By Sharon Begley and Julie Steenhuysen

NEW YORK (Reuters) - Hundreds of people with HIV/AIDS in Louisiana trying to obtain coverage under President Barack Obama's healthcare reform are in danger of being thrown out of the insurance plan they selected in a dispute over federal subsidies and the interpretation of federal rules about preventing Obamacare fraud.

Some healthcare advocates see discrimination in the move, but Blue Cross and Blue Shield of Louisiana says it is not trying to keep people with HIV/AIDS from enrolling in one of its policies under the Affordable Care Act, also known as Obamacare.

The state's largest carrier is rejecting checks from a federal program designed to help these patients pay for AIDS drugs and insurance premiums, and has begun notifying customers that their enrollment in its Obamacare plans will be discontinued.

The carrier says it no longer will accept third-party payments, such as those under the 1990 Ryan White Act, which many people with HIV/AIDS use to pay their premiums.

"In no event will coverage be provided to any subscribers, as of March 1, 2014, unless the premiums are paid by the subscriber (or a relative) unless otherwise required by law," Blue Cross Blue Shield of Louisiana spokesman John Maginnis told Reuters.

AIDS FUNDS EXEMPT FROM FRAUD CONCERNS

The dispute goes back to a series of statements from Centers for Medicare and Medicaid Services (CMS), the lead Obamacare agency.

In September, CMS informed insurers that Ryan White funds "may be used to cover the cost of private health insurance premiums, deductibles, and co-payments" for Obamacare plans.

In November, however, it warned "hospitals, other healthcare providers, and other commercial entities" that it has "significant concerns" about their supporting premium payments and helping Obamacare consumers pay deductibles and other costs, citing the risk of fraud.

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In this Wednesday, Dec. 11, 2013, file photo, Rosemary Cabelo uses a computer at a public library to …

The insurers told healthcare advocates that the November guidance requires them to reject payments from the Ryan White program in order to combat fraud, said Robert Greenwald, managing director of the Legal Services Center of Harvard Law School, a position Louisiana Blue still maintains.

"As an anti-fraud measure, Blue Cross and Blue Shield of Louisiana has implemented a policy, across our individual health insurance market, of not accepting premium payments from any third parties who are not related" to the subscriber, Maginnis said.

On Friday, CMS spokeswoman Tasha Bradley told Reuters that, to the contrary, Ryan White grantees "may use funds to pay for premiums on behalf of eligible enrollees in Marketplace plans, when it is cost-effective for the Ryan White program," meaning that having people with HIV/AIDS enroll in insurance under Obamacare could save the government money.

"The third-party payer guidance CMS released (in November) does not apply to" Ryan White programs.

Maginnis did not respond to further requests, sent after business hours, for comment on CMS's Friday statement.

Hundreds of indigent HIV/AIDS patients are dependent on Ryan White payments for Obamacare because they fall into a gap. They are not eligible for Medicaid, the joint federal-state health insurance program for the poor, because Louisiana did not expand the low-income program, and Obamacare federal subsidies don't kick in until people are at 100 percent of the federal poverty level.

Before Obamacare, the 1990 Ryan White Act offered people with HIV/AIDS federal financial help in paying for AIDS drugs and health insurance premiums, especially in state-run, high-risk pools.
Obamacare, which bans insurers from discriminating against people with preexisting conditions, was designed to replace these high-risk pools.
Starting on October 1, AIDS advocates and others in Louisiana "were enrolling anyone and everyone we could" through the Obamacare exchange, said Lucy Cordts of the New Orleans NO/AIDS Task Force.
Last month, her clients and those of other AIDS groups began to hear from Louisiana Blue that their enrollments were in limbo because the company would not accept the Ryan White checks for premium payments.
The only other carrier that is refusing to accept such payments is Blue Cross Blue Shield of North Dakota, according to a CMS official.

North Dakota Blue "restricts premium payment from third parties including employers, providers, and state agencies," said spokeswoman Andrea Dinneen, but "is currently reviewing its eligibility policies with respect to recipients of Ryan White Program funding."

'SURE LOOKS LIKE DISCRIMINATION'

Healthcare advocates are worried that the refusal to accept Ryan White payments is an effort by insurers to keep AIDS patients from enrolling in their plans and last month began pressing the issue, including with the office of Democratic Senator Mary Landrieu.

In an email reviewed by Reuters, a healthcare expert on Landrieu's staff wrote, "BCBS LA told me their decision was not due to the CMS guidance or any confusion (as we thought before) but was in fact due to adverse selection concerns. I have also recently learned North Dakota's BCBS plan has implemented the same policy."

Jessica Stone, the Landrieu staff member, declined to elaborate on the email further or to discuss her interactions with Louisiana Blue.

Adverse selection refers to the situation where an insurer attracts patients with chronic conditions and expensive care. Louisiana Blue's action "sure looks to us like discrimination against sick people," said John Peller, vice president for policy at the AIDS Foundation of Chicago.

Asked if it were engaging in efforts to avoid adverse selection by refusing to accept Ryan White payments for would-be customers with HIV/AIDS, Louisiana Blue said it was not trying to keep such customers out of its plans. "We welcome all Louisiana residents who chose Blue Cross and Blue Shield of Louisiana," said Maginnis.

LA Times: California’s ObamaCare execution has been something of a hot mess

Because getting through the signup process, dear enrollees, was only the beginning. It was only ever going to be the beginning, really.

After overcoming website glitches and long waits to get Obamacare, some patients are now running into frustrating new roadblocks at the doctor’s office.
A month into the most sweeping changes to healthcare in half a century, people are having trouble finding doctors at all, getting faulty information on which ones are covered and receiving little help from insurers swamped by new business.
Experts have warned for months that the logjam was inevitable. But the extent of the problems is taking by surprise many patients — and even doctors — as frustrations mount.
Aliso Viejo resident Danielle Nelson said Anthem Blue Cross promised half a dozen times that her oncologists would be covered under her new policy. She was diagnosed last year with non-Hodgkin’s lymphoma and discovered a suspicious lump near her jaw in early January.
But when she went to her oncologist’s office, she promptly encountered a bright orange sign saying that Covered California plans are not accepted.

Conservatives have been warning about the limited networks and fewer healthcare options that insurers were bound to use as a way to help control costs since before the law’s passage; some of the law’s cheerleaders finally caught on just a tad bit later; and now that the law has gone into effect, Americans are living it. And if organizing just the signup process through the website was such a shame spiral of royal bureaucratic incompetence on so many fronts, you know that trying to administer the actual healthcare system through it is going to be just as bad — as California also aptly showcased today. Again via the LA Times:

Admitting it gave some consumers bad information, California’s health insurance exchange pulled its physician directory for having too many errors.
Covered California made the move late Thursday amid growing frustration among both consumers and doctors over inaccurate information about insurance networks in the state marketplace.
The exchange yanked its online directory of medical providers in mid-October after acknowledging there were serious problems then with the data. It published an updated list in November. …
The exchange said Thursday that “while the combined provider directory was a useful service for many consumers, some enrollees located physicians thought to be in their plan, and subsequently discovered they were not.”

The state suggested that enrollees “who are unsatisfied with their provider network still have time to cancel their coverage and sign up with a different insurer” before enrollment ends in March — but I doubt that that’s much comfort to the people for whom signing up in the first place was a tortuously drawn-out trial, or for the people who are discovering that they cannot, in fact, keep their doctor. Or, you know, “if you want to, you can pay for it.” It’s a matter of “choice,” or something.

posted at 7:21 pm on February 7, 2014 by Erika Johnsen     hotair.com

Justice Dept. latest to apply privileges, protections for same-sex spouses

Attorney General Eric Holder announced Saturday evening that the Justice Department will now follow a landmark Supreme Court ruling on same-sex spouses, which means they will no longer be compelled to testify against each other in civil and criminal cases.
The policy changes mean same-sex spouses also should be eligible to file jointly for bankruptcy and have the same rights and privileges in federal prison as inmates in heterosexual marriages.
Prosecutors have used various legal challenges against the spousal privilege. But Holder made clear the federal government will no longer make such challenges, even in states where same-sex marriages are not recognized.
The changes will officially be made through a policy memorandum to be issued Monday.
“This means that, in every courthouse, in every proceeding, and in every place where a member of the Department of Justice stands on behalf of the United States -- they will strive to ensure that same-sex marriages receive the same privileges, protections and rights as opposite-sex marriages under federal law,” Holder said at the Human Rights Campaign’s Greater New York Gala.
Among the agencies under the Justice Department that will be impacted by the changes are the FBI, the Bureau of Prisons and the Bureau of Alcohol, Tobacco, Firearms and Explosives.
Holder also said same-sex couples will now qualify for several Justice Department benefits programs, including the September 11th Victim Compensation Fund and benefits to surviving spouses of public safety officers who suffer catastrophic or fatal injuries in the line of duty.
“This landmark announcement will change the lives of countless committed gay and lesbian couples for the better,” said campaign President Chad Griffin. "While the immediate effect of these policy decisions is that all married gay couples will be treated equally under the law, the long-term effects are more profound. Today, our nation moves closer toward its ideals of equality and fairness for all."
Holder's speech was criticized by the conservative National Organization for Marriage.
"This is just the latest in a series of moves by the Obama administration, and in particular the Department of Justice, to undermine the authority and sovereignty of the states to make their own determinations regulating the institution of marriage," said Brian Brown, the group's president. "The changes being proposed here to a process as universally relevant as the criminal justice system serve as a potent reminder of why it is simply a lie to say that redefining marriage doesn't affect everyone in society."
Holder compared this generation’s efforts to achieve same-sex marriage rights to those in the 1960s for achieving civil rights and said the stakes “could not be higher.”
"The Justice Department's role in confronting discrimination must be as aggressive today as it was in Robert Kennedy's time," Holder said of the attorney general who played a leadership role in advancing civil rights.
The changes are the most recent application of a Supreme Court ruling that struck down a provision in the Defense of Marriage Act defining marriage as the union of one man and one woman. The decision applies to legally married same-sex couples seeking federal benefits.
After the Supreme Court decision last June, the Treasury Department and the IRS said that all legally married gay couples may file joint federal tax returns, even if they reside in states that do not recognize same-sex marriages.
The Defense Department said it would grant military spousal benefits to same-sex couples. The Health and Human Services Department said the Defense of Marriage Act is no longer a bar to states recognizing same-sex marriages under state Medicaid and Children's Health Insurance Programs. The U.S. Office of Personnel Management said it is now able to extend benefits to legally married same-sex spouses of federal employees and annuitants.
Holder told his audience:
--The Justice Department will recognize that same-sex spouses of individuals involved in civil and criminal cases should have the same legal rights as all other married couples, including the right to decline to give testimony that might incriminate their spouse.
--The U.S. Trustee Program will take the position that same-sex married couples should be eligible to file for bankruptcy jointly and that domestic support obligations should include debts such as alimony owed to a former same-sex spouse.
-- Federal prisoners in same-sex marriages will be entitled to visitation by a spouse, inmate furloughs during a crisis involving a spouse, escorted trips to attend a spouse's funeral, correspondence with a spouse and compassionate release or reduction in sentence based on an inmate's spouse being incapacitated.

The Waste List

$100 Million On DOJ Conferences  - $100,000,000

In addition, the DOJ staff hosted numerous conferences around the country. In 2010 alone, the department spent nearly $100 million on conferences, which is twice what was spent two years earlier. This includes more than $600,000 in event-planner costs for five conferences, even though the need for this was not shown.
The food at these conferences was also exorbitant. For example, coffee and tea cost from 62 cents to $1.03 an ounce. At the $1.03-per-ounce price, a 12-ounce cup of coffee would have cost $12.36!

Source: Chairman Bob Goodlatte, “Excessive waste at Department of Justice,” Politico, 4/10/13

IRS-Gate

GOP proposal would require food stamp recipients to show photo ID

Several House Republicans have introduced a proposal that would require food stamp recipients to show photo identification when making purchases -- a move they say is necessary to prevent fraud in the program that aids 1 in 7 Americans.
Rep. Matt Salmon, R-Ariz., introduced the SNAP Verify Act, which would require individuals who receive acceptance through the Supplemental Nutrition Assistance Program to present a photo ID when buying products at stores that accept food stamp recipients. 
"My bill simply requires the photo identification of authorized users of SNAP electronic benefit cards at the point of transaction," Salmon said in a statement. "With over $750 million in SNAP card and food trafficking fraud each year, it is time Congress take action to address the rampant waste in this program." 
Salmon said conducting effective oversight for the program has proven difficult as food stamp spending grows. He cited a Government Accountability Office report showing that $2.2 billion in benefits were erroneously handed out in 2009 alone.
Several Republicans have signed onto the bill as co-sponsors, including Reps. Trent Franks, R-Ariz., Bill Posey, R-Fla., David Schweikert, R-Ariz., and Jack Kingston, R-Ga.
There is no federal requirement to show photo identification at the time of food purchases, though some states have the option to require a photograph of individuals using SNAP program's Electronic Benefits Transfer system. 
In Rhode Island, legislation has been filed in the state's General Assembly that would force residents trying to buy products using a food stamps to present photo ID.
The proposal by Rep. Patricia Morgan, R-West Warwick, would apply to those using electronic benefit cards to redeem other public assistance too. It would be up to retailers to check the photo ID against the name on the government-issued EBT card. 
On Friday, President Obama signed into law an agriculture spending bill that will expand federal crop insurance and ends direct government payments that go to certain farmers, while trimming the nation's  $100-billion-per-year food stamp program. 
The bill finally passed with support from Democratic and Republican lawmakers from farming states, but the bipartisan spirit didn't extend to the signing ceremony at at Michigan State University where Obama was flanked by farm equipment, hay bales and Democratic lawmakers.
Conservatives wanted much larger cuts to food stamps than the $800 million Congress finally approved in a compromise. Agriculture Secretary Tom Vilsack told reporters he did not expect the cut of about 1 percent of the food stamp budget to have a significant impact on recipients.