By Dave Lucas
http://stream.publicbroadcasting.net/production/mp3/wamc/local-wamc-977660.mp3
Albany, NY – eMedNY, the state's Medicaid management information system, is under fire. The Wall Street Journal claims the billing system is riddled with flaws, and is becoming "an increasingly costly mistake." Capital District Bureau Chief Dave Lucas reports...
eMedNY is a processing system that whizzes through 12 claims per second - churning out the checks sent to doctors, hospitals, nursing homes and other entities enrolled in Medicaid - it's the clearinghouse for financial reporting, auditing and fraud control.
Virginia-based IT company Computer Sciences Corp. (or CSC) came under state contract in 2000, developed eMedNY's operating system and got it running in 2005, three years later than planned. That was one of the problems that attracted the attention of the State Comptroller's office.
By 2007, the state was looking for a new vendor as audits and reports uncovered problems including billing errors that resulted in more than $450 million in over-payments.
Last year, Health officials issued a request for proposals for a new system, hoping to to award a new contract by the end of this year. The Wall Street Journal reports that the Cuomo Administration may be about to call off the search as CSC officials maintain the eMedNY program has NOT been mishandled.
While Cuomo officials face a late summer deadline re-thinking and reviewing eMedNY, payments to CSC continue.
Comptroller Thomas DiNapoli approved a three-year extension for CSC ending in 2012. He's all for an eMedNY upgrade.
No one wants to venture a guess as to "What would happen if CSC pulled out as vendor?" --- Elisabeth Benjamin is a vice-president of health initiatives at the Community Service Society of New York - she says whatever happens, officials must keep the Medicaid beneficiaries' perspective in mind. eMedNY annually processes some 47-billion dollars in claims - state officials are in agreement that the system needs an upgrade.