Although beholden to federal regulations, individual states direct many aspects of their Medicaid programs. Because 25 of the 50 states (as well as the federal government) have chosen the well-known “Big Four” accounting firm Deloitte to create and manage much of the technical side of their Medicaid eligibility systems, taxpayers might feel secure knowing they are being guided by a company trusted by heavyweights over many years.
Unfortunately, the government does not function like a private business. Claims of frequent errors and slow solutions would result in a timely, thorough investigation into anyone contracted by an effective private organization. If the accusations were discovered to have merit, the people responsible would be replaced. But despite Deloitte repeatedly receiving these allegations, it maintains its annual $6 billion tax-funded government contracts.
The government continues to work with Deloitte, but it tends to do so behind closed doors, so discerning whether Deloitte or the government deserves the blame proves difficult. When problems arise, it seems nearly impossible to discover if the flaws were with the original Deloitte system, the government agency’s implementation, or the agency’s own contributions to the system. Most likely, it’s a combination of all factors.
U.S. residents have the right to expect efficiency and clarity from the programs they are compelled by law to fund. The government holds citizens’ finances under a microscope, and citizens should demand at least the same level of scrutiny of government agencies and their contracted companies. Citizens and organizations representing them can do so in two notable ways: lawsuits aimed at state governments, and demands for investigations by the government itself.
Suing The State
Medicaid recipients across the country are bringing lawsuits against their state agencies and officials for wrongfully terminating their Medicaid benefits due to system malfunctions. In doing so, they can hopefully illuminate the murky source of the problems.
In Florida, which has a Deloitte contract, residents claiming state agencies improperly withdrew their Medicaid benefits have filed a class-action lawsuit to rectify the situation. A similar lawsuit in Tennessee (a fellow Deloitte state) restored Medicaid benefits to 35 residents who had seen their benefits terminated against state rules.
Because errors in the computer systems themselves clearly caused some of the issues, both Deloitte and the states employing it are being subjected to increased scrutiny, making the obfuscation of blame more difficult. Deloitte and its employing states have so far managed to remain tight-lipped about the exact causes of the failures, but continued lawsuits could render that impossible in the future.
Pressuring The FTC
Multiple advocacy groups are also lobbying the Federal Trade Commission (FTC) for an investigation into Deloitte, after a tidal wave of software errors in Texas caused mass losses of Medicaid coverage. Within eight months, at least 90,000 eligible residents lost access to their promised coverage due to the glitches.
Again, mystery about culpability and the nature of the glitches themselves has swirled around the incident. Sarah Grusin, speaking on behalf of one of the advocacy groups petitioning the FTC, noted that “Deloitte hasn’t made information public about the status of those issues, and neither has the state.”
Deloitte enjoys lucrative government contracts, financed by taxpayers. Legislators have an obligation to use those massive tax funds as productively as possible, and they also have a duty to publicly prove they are doing so. Neither is happening with the Deloitte Medicaid agreements, and taxpayers need to pressure the individuals and agencies responsible until the matter is resolved.