365体育投注ST. PAUL — Problems with a state computer system meant to simplify the application process for public health care programs have forced county workers to double-check its work more than one-third of the time, according to the latest Office of the Legislative Auditor report.
The report, released Wednesday, April 15, details the significant issues that the auditor's office identified with the Minnesota Eligibility Technology System, or METS. While the office found that METS generally complies with federal legal and data requirements, it relies heavily on human caseworkers as a backstop.
365体育投注"As a result, METS has not achieved the efficiencies that an automated eligibility determination system should provide," Valerie Bombach of the auditor's office said in a letter included with the report.
Launched in 2013, METS both supports the MNsure online insurance marketplace and allows Minnesotans to apply for coverage through Minnesota Care, the state's low-income health care program, as well as the federal Children's Health Insurance Program and Medical Assistance, the state's Medicaid program for low-income residents. State and county human service workers use it to automatically verify that those applying for coverage are in fact eligible for it by checking their information against records in other systems.
But over a recent 15-month period, the auditor's office found that county caseworkers had to manually review approximately 37% of METS applications — or 232,000 out of 624,000 — because of clerical errors and data discrepancies. The heads of the DHS and the Minnesota Information Technology Services agency, which share management of the system, defended that record in a joint letter included with the report, saying it shows they are vetting applicants more or less as intended.
365体育投注"We believe this is exactly how the eligibility process is supposed to work. If the data does not match, a caseworker needs to resolve the issue by gathering information," DHS Commissioner Jodi Harpstead and MNIT Commissioner Tarek Tomes said.
365体育投注In a phone call late Wednesday, DHS Deputy Commissioner Chuck Johnson said that the auditor's office has previously flagged the agency for its rate of manual case reviews but has never indicated what a more acceptable response rate would be.
"It’s not helpful for us if we don’t know what target we’re supposed to be shooting for," he said.
The audit also dings METS for its difficulty in communicating with the separate computer system for Medicaid. Inconsistencies between the two systems will be responsible for the lost of an estimated $76 million in federal reimbursements over the next several years, according to DHS projections from last fall.
Minnesota could miss out on reimbursements again in the future if those problems go unaddressed, DHS officials have said.
Johnson said Wednesday that DHS and MNIT have been working to better the state computer system for the past several years, and expect federal regulators to improve Minnesota's access to the raw data it needs beginning in August. The agencies might lessen the state's projected losses as a result, he said.
Issues with the DHS's funding formula for METS, meanwhile, may have led the agency to over-claim about about $10.5 million in federal funding between 2016 and 2018, according to the report.
365体育投注METS is funded by the state and federal government and takes a percentage of revenue generated by private plan premiums sold through MNsure. Building and maintaining it cost approximately $432 million between 2012 and 2019, according to Wednesday's report.