Back-End to the Future

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In November 2013 I wrote a blog which stated:

According to Henry Chao, deputy chief information officer for Centers for Medicare and Medicaid Services, up to 40 percent of the technology needed to run the new Obamacare health insurance marketplace has not yet been built and will not be ready when insurance companies start sending in bills when coverage begins January 1.

I was aghast that they had built this monstrosity and didn’t even finish it.  But like everything else, we forget and move on.  Now it is almost two years later and we find out this from the WSJ:

The Obama administration has been making billions of dollars in payments to insurance companies under the health law without being able to confirm just how much it owes each insurer, according to an inspector general’s report to be released Tuesday.

The back-end system for the Centers for Medicare and Medicaid Services to determine the exact amounts the government owes for each enrollee still hasn’t been completed.

While it is being built, insurers have been submitting estimated claims to the federal government, which has been paying the claims without knowing for sure whether they are accurate—or if enrollees are even current on their share of the premiums.

In all, the Obama administration didn’t have a firm grip on the almost $2.8 billion paid to insurers from January through April 2014, the inspector general for the Department of Health and Human Services concluded after studying a sample of the payments during that period.

 

Maybe the government should have finished the building out the back-end? I mean that sounds like it would have been a good idea.  Once again, the government fails us, many of us will have to pay these bills with our taxes and the insurers always win.  This is getting so common that it isn’t even news anymore.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  1 comment for “Back-End to the Future

  1. Steve O'
    June 20, 2015 at 9:24 am

    I must confess – I have taken to squatting here and there in the seedier parts of town, with a white coat, flip-flops and a bucket. Occasionally, some kind soul will throw coins into my bucket. I angrily dump them out, and yell, “HEY! Hey! What the hell are you doing?”
    I dump them out, and wave the bucket at them. “THIS bucket, THIS is for the flying monkeys – the ones that squirt money out their butt. When THEY fly over, I’ll be RICH! RICH, I tells ya!”
    Then they realize I am an ACA healthcare planner. A little patience, a little faith, and the flying monkeys will be here soon enough. Enough willpower makes it true. Stay away from the Risperdal, though – it clouds your mission as a government financial planner. PTOO!

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