Feb 2, 2024 - News

Medicaid's alleged software mishap

Illustration of a distorted computer with binary code flowing out of the screen with abstract shapes around it.

Illustration: Gabriella Turrisi/Axios

Hundreds of thousands of Texans recently lost Medicaid coverage due to faulty eligibility software from Deloitte, consumer advocacy groups alleged in a complaint to the Federal Trade Commission on Wednesday.

Why it matters: While the filing is focused on Medicaid redeterminations in Texas, where about 1.8 million people have been removed from the rolls since April, the advocates said the issues are part of recurring problems with eligibility systems Deloitte has provided to state Medicaid programs.

Driving the news: The complaint, which asks the FTC to investigate Deloitte for "deceptive and unfair" trade practices, said the company's software doesn't reliably conduct automatic redeterminations of whether a Texas Medicaid enrollee is still eligible for coverage, Axios' Maya Goldman reports.

  • States are supposed to check existing data to see if someone remains eligible for Medicaid before asking them to submit renewal forms.
  • Most people who have lost Medicaid coverage during the post-pandemic unwinding process have been disenrolled because of procedural issues, not because they were determined ineligible for coverage.
  • Texas' Medicaid disenrollment rate (61%) is the highest in the country, per KFF.

The other side: The Texas Department of Health and Human Services said through a spokesperson it's aware of the complaint and will work with the Centers for Medicare and Medicaid Services "to implement immediate strategies to ensure that the redetermination process operates as smoothly as possible."

Zoom out: The complaint said Deloitte was aware that its software had bugs, pointing to reports of problems in other states that predate the pandemic.

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