State Auditor Doug Hoffer. Photo by Roger Crowley/for VTDigger
State Auditor Doug Hoffer is going to put Vermont’s plans to correct ongoing problems with its health care exchange under the microscope, he said Monday.
Thousands of Vermont Health Connect customers are still having trouble making changes to their coverage, fixing billing issues or editing personal information.
“Is the state taking the steps to get this right?” Hoffer said. “We’d like to try and help answer that question.”
There have been several reports from consulting firms detailing wide-ranging problems at Vermont Health Connect, he said, as well as making recommendations to correct them.
Hoffer said he wants to examine whether salient aspects of those recommendations have been followed.
Lawrence Miller, chief of health care reform, said the administration welcomes the performance audit. The administration wants to learn from the pitfalls of Vermont Health Connect, he said.
“That’s always appropriate and useful,” Miller said.
Hoffer and his staff considered a number of focus options for the performance audit. They decided the project’s contract issues were “well trodden,” and they could add more value by looking at the state’s overall approach to building the exchange.
“What we’re doing here takes it up a notch from 5,000 to 30,000 feet to look at all these things together,” Hoffer said of the issues raised in consulting reports.
Performance audits culminate in reports with findings and recommendations, which are released to state agencies, legislators and the public. The auditor’s report will focus on how the project was managed and its recommendations will focus on how the state can improve its approach to large-scale IT projects.
The report won’t be available during the upcoming open enrollment period — the next major test for Vermont Health Connect — but Hoffer said he hopes it can be released before the end of the upcoming legislative session.
The performance audit will take close to six months, Hoffer said, and won’t begin until mid- to late-September.
That’s because Hoffer doesn’t want to overload Vermont Health Connect staff, who are still being scrutinized by the feds, according to a letter Hoffer sent to Harry Chen, interim secretary of the Agency of Human Services.
The Inspector General of the federal Department of Health and Human Services is conducting ongoing fieldwork related to Vermont Health Connect, the letter states.
News that the feds were reviewing Vermont Health Connect was first made public when Hoffer announced his intentions to audit the state’s exchange in April. At the time, he said his office was in touch with the HHS Inspector General to make sure work wouldn’t be duplicated.
A spokesman for the IG’s office pointed VTDigger to a work plan describing the IG’s intended Affordable Care Act reviews during the current federal fiscal year, which ends Sept. 30, but did not provide any Vermont specific information.
The IG released a report in July that said Vermont failed to properly check applicants’ eligibility for coverage and subsidies.
A high-level of federal oversight should be expected with a project of Vermont Health Connect’s magnitude, Miller said. The IG’s office is doing similar reviews of all state-based exchanges, he said.
Miller said Vermont has kept in close communication with the feds, and that the state has followed federal grant spending guidelines closely.
“I don’t expect any material findings” against the state for how federal money is being spent, he said.
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Mr. Hoffer’s audit will focus on the state’s actions to correct problems, however it would be good if he could also look at the initial analysis the state did and documented to justify building it own proprietary exchange versus using the federal exchange.
To date Vermont has spent/is committed to spend more than $85 million for it’s own state exchange. The federal exchange could have been used at a cost of only $4 to $5 million. The $4 to $5 million figure is based on what it cost New Hampshire to get on to the federal exchange.
So what analysis did the Shumlin administration do and how is it documented to justify the proprietary effort?
Mr. Hoffer, the taxpayers footing the exchange bill have a right to know how the Shumlin administration decided to go it alone on this project. Additionally, one would think that you, as the State Auditor, would want to see the rational behind such a significant decision.
In meantime and in the interest of transparency, the Shumlin administration should now make public the analysis it did to justify the decision to build its own exchange.
I spent 15 years making video games. Very, technically challenging video games. This is similar to a game in developemnt.
What I would like to know is if the development team had a QA system in place working alongside the developer documenting the bugs as they found them and relaying the bugs to the developers to be fixed before releasing the product.
What I’ve been observing seems to me that we, the people, are the QA team, and the bug list is too long to ship the product to us the consumer.
It’s about time.
Seriously, though, what took Hoffer so long to look into this? Vermonters (me included) have been having tremendous troubles with Health Connect for almost a year. It has been, without question, one of the biggest snafus in Vermont governance in decades. It was clear to everyone that last year’s roll out of Health Connect was a mess. But it took our State Auditor a year to do what he’s supposed to do: audit our state government.
Interesting, too, that Hoffer’s proposed audit won’t be available until well after the election. I’ll bet his Democratic Party brethren will be giving him a nice little belly scratch for orchestrating that delay — just what lapdogs like best!
But, beyond the electoral stalling, it’s equally disturbing that Hoffer’s audit won’t be available before the open enrollment period at the end of year. As a result, those of us mired in Vermont Health Connect’s many, many problems (getting an invoice, for example) won’t get any help from this audit or the auditor’s office.
Color me unimpressed.
Michael, the question becomes….is this really going to be an independent audit or just another ‘dog and pony show’ where the Shumlin administration gets to dictate what the final report concludes? I agree! What took Hoffer so long?
Why not do something worthwhile. We all ready know how the Vermont Health Connect fiasco is going.
How about finding out how the Vt Prescription Monitoring System has been doing. We have ongoing the worst opiate addiction problem in Vt history yet not a peep from VPMS.