REPUBLICAN GOVERNOR'S ASSOCIATION: Dem Gov Gina Raimondo Facing New Questions After Mismanaging State Social Services In Rhode Island

Source: Republican Governor's Association

Republican Governor's Association issued the following announcement on April 11.

Democrat Governor Gina Raimondo’s mismanagement in Rhode Island is leaving the neediest residents of her state high and dry as she risks federal funds for assistance programs. 

According to the Providence Journal, a new report by Rhode Island’s Auditor General blasts state social services under Raimondo’s administration, describing them as a “maze of government-run assistance programs for the poor and elderly in Rhode Island in serious disarray and in jeopardy of losing millions of federal aid dollars.”

The audit claims that discrepancies with Rhode Island’s Medicaid payment systems “compromised the state’s ability to make sure payments are only made on behalf of eligible individuals” with 16,000 more recipients reported than there were in the state’s flawed new electronic eligibility verification program. As a result, the state drastically overpaid for services, costing millions in taxpayer dollars while leaving Medicaid recipients experiencing unacceptable delays for service.

With the ACLU suing the state as a result of the debacle, claiming “problems are getting worse, not better,” Raimondo’s failed management of her state’s social services raises new questions as her administration continues to fail to follow through for those it is responsible to. Rhode Island deserves better leadership.

The Providence Journal reports:

“A newly released state audit paints a picture of a maze of government-run assistance programs for the poor and elderly in Rhode Island in serious disarray and in jeopardy of losing millions of federal aid dollars.

While some of the problems may no longer be as severe, the American Civil Liberties Union of Rhode Island — which is suing the state for failing to quickly get food stamps into the hands of people who urgently need them — said on Monday that problems are getting worse, not better.

The report by state Auditor General Dennis Hoyle puts the spotlight on this and other significant problems, among them data discrepancies.

The state’s Medicaid payment system reported 16,000 more recipients than the state’s flawed new electronic eligibility verification system, alternately known as ‘UHIP’ and ‘RIBridges.’

This compromised the state’s ability to make sure ‘payments are only made on behalf of eligible individuals and … resulted in duplicate capitation payments being made to managed care organizations,’ the report said.

Hoyle said it is not yet fully clear how much the state may have overpaid as a result of the ‘problematic’ communication between these two electronic systems.

Among the other significant findings of the annual report issued Monday morning on state operations in the fiscal year that ended on June 30, 2017:

Medicaid: ‘In many instances, particularly for Medicaid applicants requiring long-term care services and supports, the State is not complying with timely determination of Medicaid eligibility requirements … [resulting] in significant delays in determining eligibility and necessitating advances to long-term care service providers.’

Among the residual complications: the state advanced $12.5 million to nursing home operators initially for delays early on in making Medicaid eligibility determinations for patients, which were federally reimbursed “but did not meet criteria for reimbursement.” (The state’s advances have since swelled to about $130 million.)

Subsidized child care: “The ‘eligibility system lacked effective income validation controls … which impacted program eligibility determinations and the amount of required parent cost-sharing amounts. RIBridges was not consistently calculating correct cost-sharing amounts for both parents and providers, which required supplemental payments to childcare providers.’

Temporary Assistance for Needy Families: ‘Due to the limited operation and effectiveness of controls over eligibility for the [Temporary Assistance for Needy Families] program during fiscal 2017, the state did not comply with the TANF eligibility requirements … did not prompt employment and career advisors to update/develop new work participation plans … did not comply with the Income Eligibility and Verification System requirements.’

Of the Supplemental Nutritional Assistance Program, formerly known as Food Stamps, the audit report said: the state’s new computer system, which has swelled in cost from $364 million to close to $500 million.

Of the state’s new computer system, the cost of which has swelled to close to $500 million, the report said: ‘The State has experienced significant compliance challenges for its largest human service programs with implementation of the … integrated eligibility system.

‘These challenges significantly impacted the State’s ability to comply with federal regulations relating to eligibility and, for certain programs, benefit payments which are determined by RIBridges’ for Medicaid, the Children’s’ Health Insurance Program known as CHIP, TANF, SNAP and the child-care subsidy program known as CCAP.

The ramifications still include: ‘potential (1) disallowance of certain system development costs, (2) sanctions imposed by federal grantor agencies for noncompliance with specific program requirements, and (3) requests for return of federal funds for benefits provided to ineligible individuals. Additionally, advances have been made to certain provider groups due to untimely eligibility determinations which has precluded the processing of Medicaid claims. Settlement of such advances by subsequent adjudication of claims for eligible individuals is anticipated but uncertain. ‘

‘It is important to keep in mind that this report reflects a finite time period, ending in June of last year,’ said Ashley O’Shea, spokeswoman for the state Department of Health and Human Services. ‘We’ve made considerable progress since then in addressing many of the findings. The State continues to hold Deloitte accountable to delivering a fully compliant RI Bridges system. The State continues to withhold payment from Deloitte until RI Bridges is fixed and meeting performance targets.’

A second phase of Hoyle’s report, containing management comments, will be out in the next 10 days.

On Thursday, the House Committee on Oversight is scheduled to hear a presentation from the Deloitte Consulting, the private company that designed and installed the troubled UHIP (Unified Health Infrastructure project) computer system.”

Original source can be found here.

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