Vermonters For Health Care Freedom
Special Edition
4/10/15
Vermonters For Health Care Freedom is a reliable source of candid and insightful critiques of Vermont’s health care reform efforts. Through research and our own network of experts, VHCF regularly updates Vermonterson the state’s latest health care reform efforts. VHCF is proud to have played a significant role in exposing the pitfalls of a government-run single payer health care system, which fortunately met its demise at the end of 2014. In 2015, we focus on the impacts of the Shumlin administration’s continued push for a government-run health care system. We keep our readers informed about the facts that even the Shumlin administration would prefer not to reveal. No other Vermont organization is dedicated solely to this work.
Is Shumlin Doing It Again?
Gruber Redux? The $6.6M Optum Invoices
As yet another indicator that the Shumlin administration cannot be trusted, an extra measure for oversight of Vermont Health Connect (VHC) was slipped into the FY2015 budget adjustment act before the House gave it unanimous preliminary approval.
Prompted by an amendment on the floor by Rep. Mary Morrissey, R-Bennington, a line was added to the bill requiring the chief of health care reform to produce a series of reports detailing the finances of the health exchange by March 11, 2015.
On April 1, 2015, Vermonters For Health Care Freedom (VHCF) issued a public records request to the Department of Health Access (DVHA), requesting copies of: “any and all invoices received from OptumInsight consultants between July 1, 2014 and April 1, 2015, as well as copies of any and all payments made by the State to Optum during the same period”.
We wanted to advise our readers about how their tax dollars were being spent. We also wanted to know if the Shumlin administration had learned a lesson from the Jonathan Gruber contract fiasco and was actually managing the Optum contract money.
Recall that Optum is the second IT contractor hired by DHVA to try to make Vermont Health Connect work. The first was CGI, which was paid $127 million before being fired for nonperformance. Investigative reports showed that the Shumlin administration failed to manage the CGI contract at all. Optum was hired to step in to fix the mess CGI left behind, and the state expects to pay them $57 million more.
Meanwhile, Vermont Health Disconnect still doesn’t work.
On April 7, 2015 DVHA responded to our request by providing detailed Optum invoices covering June – September 2014, totaling $6,632,570 for 4 months work. The invoices covered several “tasks” of the Optum project. One of the major tasks was to manually process the huge backlog of “change of circumstance” requests made by Vermonters, which VHC still cannot process.
Missing were any invoices for the six months from October 2014 – April 2015. As the work is still ongoing, VHCF finds it strange that Optum has not billed the State for any work in the past 6 months.
Stranger yet is the fact that the state says it has not yet paid Optum - for ANY of the work - going back to June 2014! DVHA’s cover email stated, “Please also note that none of these invoices have been officially approved by the contract manager, accepted by the State, or processed for payment. DVHA is currently undergoing this process”.
Why hasn’t the State paid Optum in almost a year? Was the money not there? Does Optum enjoy working for free?
Apparently the Optum contract was sailing along nicely until the flap over the Jonathan Gruber contract arose in January 2015. Recall that Gruber did not provide any verifiable detail for the work he billed for, and the state paid him tens of thousands of dollars anyway. The Shumlin administration found itself with egg on its’ face when this impropriety was made public. Once State Auditor Doug Hoffer began looking for detailed invoices, the state immediately stopped paying Gruber.
Around the same time as the flap over the Gruber mess, DVHA suddenly amended its contract with Optum to require detailed invoices. As a result, all the invoices that DHVA just sent to VHCF were “issued” in March 2015. The 2014 work dates are still there, but the “billing date” is now March 2015. Although VHCF asked for “all” invoices, no 2014 invoices were provided.
Did Optum not submit any invoices between June 2014 and March 2015? Or were the initial invoices missing verifiable and accountable detail so the state had to scramble to get new ones?
It appears that the Gruber flap may have occurred just in time, or the Shumlin administration might still be paying out tens of millions of dollars with no evidence that the work was performed or who performed it. The February 2015 amendment to the Optum contract and the strange issue of all 2014 invoices in March 2015, point to the fact that the legislature forced the administration to be accountable for taxpayer dollars.
It should be fairly clear by now that the term “Governor Shumlin” is an oxymoron. The dictionary defines “govern” as: “conduct the policy, actions, and affairs of (a state, organization, or people); "he was incapable of governing the country"; synonyms: preside over, control, be in charge of. “
Sadly, this Governor doesn’t govern, can’t manage, and his word cannot trusted.
Optum Costs Are Exhorbitant
Vermont is in a huge budget crisis. Yet Optum’s invoices show that their lowest levelemployees, customer service reps, bill out at $38 - $40/hr. ($79,040 - $83,200 annually). There were 174 reps billed for in June 2014, a total of $583,570. September 2014’s customer service invoice totaled $708,333. It seems inconceivable that Vermonters could not have been hired and trained to do this work, at far a more reasonable cost.
Hourly rates for other Optum contracted personnel: $161, $178, $207, $230, $259, and one individual who bills at $460/hr.
While much of what pays for Optum has been federal money, starting in 2015, Vermonters must pick up the operating costs of Vermont Health Connect.
Last year, former DHVA Commissioner Mark Larson told the Senate Finance Committee that the exchange would cost the state $14 million a year. Legislators were aghast at this year’s $51 million price tag.
In the words of Senate Finance Committee chair Tim Ashe, “That’s not a structural problem, that’s a technological fiasco.”
No comments:
Post a Comment