It was never a secret in the state capital that one of the immediate messes that Pat McCrory would inherit as governor involved a new system to process Medicaid claims.
For those not involved in health care, a computer billing system might seem a strange hurdle that could potentially cause a major stumble for a governor.
When that system handles $12 billion in claims, money that 70,000 health care providers depend on to pay themselves, their staffs and meet expenses, the potential for mayhem is indisputable.
To put those numbers in perspective, if Medicaid were an employer, those 70,000 providers would represent the state’s second largest workforce, behind only state government itself and well ahead of North Carolina’s largest private sector employer, Walmart.
If even some portion of that $12 billion in payments become clogged in process, doctors, nursing home owners and other health care providers will have trouble meeting payroll, paying bills and keeping their operations running smoothly.
No politician wants the kind of wailing that will result to come down on his or her head.
That scenario has always been a possibility with the new Medicaid claims system, dubbed NCTracks by the McCrory administration, because of delays, cost overruns and other problems that have beset the project from its beginning.
A highly critical state audit released during the Perdue administration noted that state officials had done a poor job requiring the oversight needed to keep the $484 million project on time and functioning properly.
A more recent audit questioned whether testing of the system has been adequate to ensure that it can handle the claims. After further testing, a consultant hired by the McCrory administration said it was ready to go, even if less testing posed more risk.
McCrory and his top health officials have pointed out that they are not responsible for past mistakes when it comes to the claims system.
They are right. They aren’t.
They have, though, chosen to move forward, without further delays, taking a path that does not involve reassessing the original choice of the system and contractor, Computer Sciences Corp. (CSC).
Not surprisingly, the previous claims system operator and CSC rival for the new contract, Hewlitt Packard Enterprises, wanted that kind of review, arguing that the state is headed toward disaster.
The problem for the McCrory administration is that switching back and forth between competing claims systems is just about impossible.
Now that the switch has been flipped (the system change took effect July 1), it is pretty much new system or bust.
McCrory recently told the Associated Press that his administration had prepared for all possibilities regarding the new system. They have also beefed up staff to respond to any problems.
The governor better hope that is the case.
He may not have laid out this entire course, but he did oversee the final leg of the journey.
Like it or not, he has ownership now.
—Scott Mooneyham covers the state Legislature for the Capitol Press Association.