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United States Government Medicine

HealthCare.gov Can't Handle Appeals of Errors 208

Posted by samzenpus
from the that's-some-good-work-there-lou dept.
PapayaSF writes "The Washington Post reports that roughly 22,000 people have claimed they were charged too much, steered into the wrong insurance program, or denied coverage, but the HealthCare.gov website cannot handle appeals. They've filled out seven-page forms and mailed them to a federal contractor's office in Kentucky, where they were scanned and entered, but workers at CMS cannot read them because that part of the system has not been built. Other missing aspects are said to have higher priorities: completing the electronic payment system for insurers, the connections with state Medicaid programs, and the ability to adjust coverage to accommodate major changes such as new babies. People with complaints about mistakes have been told to 'return to the Web site and start over.'"
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HealthCare.gov Can't Handle Appeals of Errors

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  • Coders (Score:5, Insightful)

    by Stolzy (2656399) on Monday February 03, 2014 @07:22PM (#46145589)
    Maybe they should have hired actual coders to do the job.
    • Re: (Score:3, Insightful)

      by drpimp (900837)
      Or instead, maybe they should have hired architects, engineers, and/or developers and not "coders" or "programmers".
      • by Cryacin (657549)
        Pleased to be reverting resume's for urgent posting job.
      • Or instead, maybe they should have hired architects, engineers, and/or developers and not "coders" or "programmers".

        No. They need more people who know how to do this [programmin...fucker.com].

        • Re:Coders (Score:4, Insightful)

          by superwiz (655733) on Tuesday February 04, 2014 @12:02AM (#46147159) Journal
          That's EXACTLY how you get to a disaster -- you hire people who get off on coding and write throw-away crap "because it works." It works once. And, usually, only on your desktop.

          On an unrelated note, your signature is unrelated to the argument it makes. Correlation is not causation. That's a truism. Correlation is correlation. The statement which actually says something is "correlation does not imply causation."

          • That's EXACTLY how you get to a disaster -- you hire people who get off on coding and write throw-away crap "because it works." It works once. And, usually, only on your desktop.

            Sure, one-off "because it works" coding is one way to get to a disaster. Another way is to spend so much time on "development methodology" as opposed to actual coding that you can't possibly produce a working application before the deadline. My bets are on the latter in this case.

            On an unrelated note, your signature is unrelated to the argument it makes. Correlation is not causation. That's a truism. Correlation is correlation. The statement which actually says something is "correlation does not imply causation."

            I'd have used the longer version except it wouldn't fit in Slashdot's .sig limit. ;) Either way, I stand by my statement--both "correlation is not causation" and "correlation does not imply causation" are true, but if you use ei

      • Re:Coders (Score:5, Insightful)

        by lgw (121541) on Monday February 03, 2014 @07:45PM (#46145795) Journal

        It always seemed to me that people who insist on the distinction are missing the fact that it's the "coding" part of the job that matters in the end. Yes, it's good to have a sane design and so on, but that only has value because it makes for better code. And save me from architecture astronauts who don't write code any more, and so produce designs of no value whatsoever.

        • Re:Coders (Score:5, Funny)

          by RightwingNutjob (1302813) on Monday February 03, 2014 @08:05PM (#46145887)
          Design without code is masturbation. Code without design...well, it's not masturbation, it isn't exactly sex either, but something gets fucked up, that much is for sure.
          • Re:Coders (Score:4, Interesting)

            by Maxo-Texas (864189) on Monday February 03, 2014 @08:50PM (#46146125)

            hehehehe.

            Laughed out loud. Very fresh and humorous.

            For a project this size, you really need multiple layers of architects and then multiple layers of coders.

            I'm sure this will be fine in another year or so. I'm amazed they got so much done under the conditions and constraints I've heard they worked under.

            • by lgw (121541)

              I'm amazed they got so much done under the conditions and constraints I've heard they worked under.

              I agree: the blame here falls at the highest levels, where the "conditions and constraints" come from.

              • by kenh (9056)

                They gave themselves over three years to implement the website, but choose to spend most of that "refining" their design.

                Then, once they implemented the website (the parts of the website they choose to implement, saving "payment" and "appeal" backend systems for later), they allowed themselves 3-6 months for every uninsured American to get on to the website and apply for coverage. If there was a problem with the website, they had a plan - they had paper applications, call centers, and in-person navigators t

          • by superwiz (655733)
            Yeah, let me fix that for you. Code without design is rape. It self-gratification of whoever was lucky enough to create the prototype and then a slow, violent fuck fest of whoever has to make something useful without throwing that prototype away.
        • by sjames (1099)

          Code without design will do something, but it may bear no resemblance to solving the problem or even running to completion. I'll agree that coding has to happen at some point or nothing happens.

          I'll also agree that architects should do at least some coding in order to remain grounded in reality.

      • Re: (Score:2, Flamebait)

        by rtb61 (674572)

        The real answer it obvious, it would have been a whole lot simpler to go with universal health care, charge a 1% premium on everyones income and tie it to the existing social security number. Nope, the Uncle Tom dope had to go with stuffing of private insurance company profits and corporate executive bonuses and then those executives still turned around and attacked the idiot because the crazy complicated scheme eliminated junk policies (ones that charged fees but basically provided zero coverage). Insuran

    • maybe they should of give the them time and other stuff needed to do there job.

      I head QA only had a week and the backend was a big mess with it taking a long time to get info on data formats.

    • by Darinbob (1142669)

      Or real managers who know how to manage projects rather than just setting deadlines and telling the powers that be that everything's under control.

    • by gstoddart (321705)

      Maybe they should have hired actual coders to do the job.

      Do you really believe they didn't?

      My guess, the people running the project on the government side did a piss poor job of running the project, had no idea of what they were building, and provided the contractor with conflicting and confusing information, and probably kept changing their priorities as they went.

      I'm skeptical the change in who is implementing it will address any of these issues. Because the people overseeing it will likely still be inep

  • by DarkOx (621550) on Monday February 03, 2014 @07:23PM (#46145601) Journal

    I have been advising anyone who will listen to keep their personal information the hell away from that site. My assumption is the fraudsters that eventually got hold of it would be criminals, not the government and the insurers themselves.

    In retrospect I am really not surprised.

    • by Mitreya (579078)

      I have been advising anyone who will listen to keep their personal information the hell away from that site.

      Fortunately, it plugs into the Federal databases for all sorts of information to verify account info (from what I understand). So the website has access to your information by default.

    • Re: (Score:2, Insightful)

      by argStyopa (232550)

      I'm curious by what criteria you actually distinguish criminals, fraudsters, and government? The distinction has grown increasingly fuzzy or, perhaps, irrelevant.

  • Please fasten your seatbelts, we seem to be encountering some turbulence.

  • by nurb432 (527695) on Monday February 03, 2014 @07:35PM (#46145697) Homepage Journal

    If you created this huge of a disaster you would have lost the contract, and most likely have to pay back any payments made. You would also be on a virtual blacklist as being completely incompetent.

    But here in the federal government.. it doesn't work that way. You get rewarded.

    • by Jaime2 (824950) on Monday February 03, 2014 @07:50PM (#46145809)

      When I worked for a Fortune 50 company, we once had corporate IT charge us $1.7 million to tell us that it would cost $4.5 million to make a simple e-commerce web site for a division that had a catalog of 2000 products and did about 250 orders per day. Everyone on that team was praised and the local GM that refused to go forward with the project was eventually pushed out. The project eventually happened.

      They now have a maintenance team of five people dedicated full time to that web site.

      • Yea, our vendor now charges us $10,000 to give us a QUOTE on potential projects. It's kind of a joke at this point.

      • by Firethorn (177587)

        Ummm... Wow.

        The only way I could see that is if the 2k products each has at least 10 options and the average order is like 10k items at an average price of $100 per.

        Of course, with purchases that big you'd generally be holding parties and/or sending personal reps to the purchasers.

    • Ok. The problem is that the government is not allowed to sue the firms to get their money back. For example see the case with Oregon and Oracle. Oregon paid Oracle the money and got shit in return. The blame lays squarely at Oracle's feet.
    • Re: (Score:2, Informative)

      by Anonymous Coward

      If you created this huge of a disaster you would have lost the contract, and most likely have to pay back any payments made. You would also be on a virtual blacklist as being completely incompetent.

      Sorry, I have to call Bullshit on this. Shit like that is common place in private sector, too. The bigger the project, the more waste and nonsense. Biggest projects don't even make it. There are fortune 500 companies that pay millions into projects that never get delivered, are delivered with lack of working aspects, or have their scope severely rolled back. But because this information is in private sector, it get's buried away from where the public, or especially the investors might see it.

  • by Daniel Dvorkin (106857) on Monday February 03, 2014 @07:45PM (#46145789) Homepage Journal

    ... I personally know several people, in several states that have not established their own exchanges, who have signed up for "Obamacare" using the federal site and are now taking advantage of much better coverage, at a much lower price, than they could have received before the ACA went into effect. The problems are real and clearly need to be fixed, but beware of confirmation bias--every single problem is going to get lots of press, while successes go unnoticed because they don't fit the "if it bleeds, it leads" paradigm.

    • by Frobnicator (565869) on Monday February 03, 2014 @08:04PM (#46145875) Journal

      I agree, I also know people who have saved money. For them it worked out. Yay, them.

      However, I was laid off and needed to use the system in December. Unemployment sucks, especially in the US. In early December I was told my application went through and I would get coverage, and was given a bunch of information that I printed. The second week of January (remember: I was in before the date when I was "guaranteed" to get coverage by Jan 1st) I was told there was an error in the site, all the information had been sent to the wrong place, asked to start the application process over. This is exactly what the original story complained about.

      But that isn't all.

      Saturday (this weekend) I got some snail mail that I was not covered, could not be covered through them, and told that there were numerous errors in my data. (For example, my wife was listed as a paid employee of my wife, a corporation based in my state, and was required to provide six months of pay stubs.) Today I spent most of the day on the phone with agents who could issue apologies but could not issue policies nor modify the data. They again instructed me to apply again (the third time).

      Unfortunately I have some medical needs that cannot be put off, so I'm facing the horrible prospect of being a recently laid off tech worker who is being forced into medical debt while unemployed. (Currently only about $1,800 that would normally be covered by the insurance I lost with the layoff.) My little nest egg is vanishing surprisingly fast as I hunt for a job.

      Just like the original story, I was advised to simply start the process over. Multiple times, including today.

      As is frequently pointed out, the US medical billing system is badly broken.

      • You could have kept your employer plan through COBRA. Why did you not do it?
        • You could have kept your employer plan through COBRA. Why did you not do it?

          Due to a pre-existing condition, he couldn't bend over far enough.

          • by kenh (9056)

            Cobra is the extension of existing coverage, his "pre-existing condition" would not have been a factor - he would not have to apply for coverage, he would only need to start paying the full cost of his previous coverage.

            Besides, denying anyone coverage because of a pre-existing condition is illegal, remember?

        • You could have kept your employer plan through COBRA. Why did you not do it?

          Yes, for the low, low price of $2700 per month I could continue my insurance through COBRA.

          The whole reason of going through the healthcare exchange was to find out about less costly alternatives. Like the $700 plan that the site recommended, and that I signed up for, and was guaranteed coverage for, and then was told the paperwork was lost due to government error, and to try again. And after the second attempt, to repeat the process.

          So yes, I could have done that. And if the government's newfangled syste

    • Re: (Score:2, Interesting)

      by Anonymous Coward

      Better care? People, such as myself, who had to sign up under Obamacare only have a small fraction of the doctors available to them compared to everyone else using regular insurance. 15% of the doctors in my county now take my insurance, down from over 70% that took my PPO before this law came into effect. And I'm paying 40% more than I was before with three times the deductible.

      Sure, I'm one person in a system of millions. But I'm one of the ones that got screwed and I know plenty of other people in the sa

      • by roc97007 (608802)

        > And I'm paying 40% more than I was before with three times the deductible.

        That's interesting... that's almost exactly the numbers we saw. Wife and I both saw our company insurance dropped when Obamacare went into effect, and the replacement was a little bit more than 40% more expensive with almost exactly 3 times the deductible, for a much smaller pool of doctors. I'm told that the strategy is to live off your FSA for the first 3 - 4 months of a calendar year until your deductible gets paid up.

        Appare

      • You responded to "not everyone had a bad experience" with "I had a bad experience", which was a given, and redundant.

        Your further extrapolation was clearly buttressed by your anecdote, and therefore colored by it. Specifically, you feel wounded, and attribute things that have not happened yet and probably will not, to the program as you have experienced it, not to facts you could research.

        I only respond so I can find this later as a textbook example of egocentric pessimism. The need to post your anecdote in

        • by ScentCone (795499)
          Shut up you pompous ass.

          He's telling you exactly what he experienced in real life. Like him and the person he responded to, my wife and I also saw our coverage canned because of the ACA. To replace it, we must now pay roughly double the monthly premium, a hugely higher deductible, and have lost access to the doctor we've been using for 20 years. The best local hospitals are now off limits, too. But luckily, now that we're past child-bearing years, we've got free maternity care ... so, there's that.

          Tel
    • Washington post has a great article with lots of anecdotes about people who've suffered and now have covererage.

      The ACA is great if you make about ~$15k to ~$45k.
      It's a wash above $45k to about $80k- and you need medicaid below $18k.

      From $80k up- or if you have a very large family with lots of kids, it appears to be painful until you make so much money that $12,000 a year doesn't matter- I'd say around $350k. It's more a philosophical loss there.

      However- everyone benefits from the preexisting condition cha

      • Actually the insurance premiums make a giant step function when one earns greater than approximately $47K. My partner's insurance went up 111.3% (Kaiser) with the cheapest "bronze" policy. Beforehand, she only sought major medical coverage and had about the same deductible. Her premium increased from a little under $300/month to about $590/month (I don't have the exact numbers here but I do recall the 111.3% increase number). She's 61 years old and now has the benefit of prenatal care/birth control and
        • It depends on what state you are in. I know plenty of people making 50-60k who got plans on the exchanges that were plus of minus 10% of what they were paying before.
        • by Velex (120469)

          can get a gender change with insurance

          Ok, I'm going to call you out as a troll.

          This has been seriously pissing me the fuck off. Where the hell do I sign up for one of these free Obamacare sex changes?

          Is the right just misinformed and free phalloplasty and testosterone HRT are available and they assumed that assigned males would also be given free vaginoplasty and estrogen HRT?

          I don't know and don't care. Unless that's the case, you are completely full of shit. At the very least it doesn't excuse this rhetoric that Obamacare is so evil

        • by Firethorn (177587)

          She's 61 years old and now has the benefit of prenatal care/birth control and she can get a gender change with insurance should she decide to grow a dick. This whole thing is a catastrophe. The net result to the middle class (actually, anyone that is single earning over $47K) is getting to pay more than twice the premium for similar coverage.

          Given that the oldest mother on record is 73 [wikipedia.org], she has a few years of 'possible' left. ;)

          More seriously, part of Obamacare was getting rid of all sorts of weird carveouts. Consider that birth control and hormone replacement therapy are very similar. There are actually medical reasons to give a women male hormones other than transition- it's extremely rare, yes, but isn't that what insurance is for? If the adjusters are doing their job, they'll realize that the odds of your partner having another child rou

    • From what I saw, coverage is cheaper but deductibles are WAY higher.

    • "Better coverage at lower rates"

      Serious question, not a troll: How many of those policies are subsidized? From what I've heard, that's the way people wind up with a cost reduction.

      - If they're not subsidized, then I hypothesize that the people should have shopped around - the policies were likely available.

      - If they *are* subsidize, then we enter this discussion: Why should person A be able to pay their insurance using person B's wallet?

  • by some old guy (674482) on Monday February 03, 2014 @07:50PM (#46145807)

    Single-payer universal nationalized healthcare is right around the corner.

    Just a few more insurance rate hikes and government regulatory fiascos should do the trick.

    I used to be against it. Now it looks like a blessing.

    • by Anonymous Coward

      Let's see here: massive, corrupt, inefficient and unaccountable bureaucracy fails to build and operate a website to manage ACCESS to health INSURANCE....not even ACTUAL HEALTHCARE......and YOUR solution is to say "let's put it in charge of providing the ACTUAL care"?????

      REALLY?????

      Can I please have the names of the drugs you are on? I'd love to see the utopia you are seeing, but I suspect those drugs kill IQ points, are highly addictive, lead to hallicinations and will eventually either be banned as "too da

  • by erp_consultant (2614861) on Monday February 03, 2014 @07:50PM (#46145811)

    that the government keeps hiring firms like Accenture. This is not the first time they have been involved in failed government IT projects. Here is just one of many examples: http://www.theregister.co.uk/2... [theregister.co.uk]

    Accenture has learned how to game the system. A system that, for large scale government projects, is very difficult to break into. The contract language makes it very difficult, or impossible, to bid on if you are a small company.

    Both the Democrats and the Republicans know that the procurement system is broken and yet neither one of them have offered any concrete solutions.

    The failure of Healthcare.gov is not news. It's business as usual. The difference is that healthcare.gov affects many people more directly so it has higher visibility. Many of the other failed projects do not have the same direct impact so they appear in the news for a little while and are then swept under the rug.

    • Accenture -- weren't they the company that worked for Enron but in the aftermath of the fraud and the role they played in it they renamed the company to "Accenture." Or did they rename again and this company took the name? I am pretty sure Accenture was the name they picked after the Enron disaster.

      Government flops that involve voters are a good thing; they can hold somebody accountable which is far more than they can do with businesses they are bound to.

      Politicians are made or broken on how they handle

      • Accenture used to go by the name Andersen Consulting. Not sure if the name change had anything to do with what you mentioned above.

        • It does. Arthur andersen folded after Enron, and the bits that were left over got rebranded (since they did not want the stigma from the Enron fiasco attached to their name)

  • by Greyfox (87712) on Monday February 03, 2014 @08:06PM (#46145889) Homepage Journal
    Was that in the requirements doc? There was a requirements doc, wasn't there?
  • "We’re making our source code freely available on GitHub" [healthcare.gov] and it's a promise they made good on... until the site launched. [theverge.com]

    so... is it time to post the code again... or ever?

  • clusterfuck?

    Best to scrap the whole thing, law and all, and start over. And this time please don't leave it up to a community organizer and his gang.
    • by tftp (111690)

      It's always a great idea to question architectural plans once you bulldozed the entire neighborhood :-)

      The problem is that old policies are dead and buried. Any new policy that is issued under the "old" system would cost twice as much, simply because (a) insurers lost a ton of money already on all those changes, and (b) it's a good time to raise the prices across the board (now that all insurers are in a similar position.)

      The only winning move was to not play. Leave the sleeping dogs alone. A change in

    • clusterfuck?

      Not so much. 22,000 is a goodly number of people, but it represents almost exactly 1% of people who have signed up so far. It's aggravating and stressful and certainly not a good thing, but it's also not the epic disaster that you seem to think it is. (And honestly, prior to the ACA, how many of those people would have been dealing with different but equally frustrating problems from their insurers anyway--and how many just wouldn't have access to health insurance at all?)

      • by kenh (9056)

        Those 22,000 people signed up for coverage to start in January, but if their coverage did start, it was wrong, the website messed it up, and they are either uninsured or insured but paying the wrong amount or getting the wrong coverage, and the government doesn't even seem to have a plan to review the 22,000 seven page appeal forms anytime soon.

        Any idea when the appeals process will be implemented?

        Any idea when their insurance policy will be corrected?

        Private insurers had a motivation to correct these probl

  • If the government can't put together a website, what in the world makes people think it can manage the complex healthcare system? The pain is only beginning. The failed amateur website will be nothing compared to the government crashing our healthcare system.

    • by kenh (9056)

      Wait till the other 95% of the healthcare plans in America become subject to the Employer mandate - the current fiasco only impacts the uninsured and 5% of those who arranged for their own coverage (the individual market)...

  • So I don't have to deal with this stupid bullshit.

    How NOT to implement socialist^H^H^H^nationalized healthcare.

  • the smokers, obese, alcoholics and drug users don't have to change their ways, right? They can continue to choose lifestyles known to increase health risks while increasing the costs for the rest of us.

    Apparently it's not an invasion of privacy or government overreach to force people to hand over their money to private companies or have the government forcibly extract the money from one's bank account whereas making people lead healthier lives is.

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