Health website transactions fail 10 percent of time: U.S. official

Fri Dec 6, 2013 7:05pm EST

1 of 2. A man looks over the Affordable Care Act (commonly known as Obamacare) signup page on the HealthCare.gov website in New York in this October 2, 2013 photo illustration.

Credit: Reuters/Mike Segar

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(Reuters) - As millions of people shop online for new insurance plans under President Barack Obama's healthcare reform law, about 10 percent of applications to the main website are not being accurately transmitted, a government spokeswoman said on Friday.

The error rate has improved since HealthCare.gov's disastrous debut on October 1, which created a political crisis for Obama as opponents and supporters of the law questioned whether the most sweeping social program since the 1960s was rushed well before it was ready.

Last week, the White House wrapped up a five-week emergency effort to fix the most obvious of the website's technical problems and between midnight on Sunday and noon on Friday, government health officials said 3.7 million people visited.

But the current level of mistakes deeper into the system are creating a new workload for insurers to verify the details of their new members and could lead to unwelcome surprises for consumers if there are mistakes in new policies that take effect on January 1.

HealthCare.gov relays information about new customers in so-called "834" transaction forms to the private insurance companies that provide the health plans. The portal serves people in 36 states while 14 states are running their own online marketplaces.

"We believe nine of 10 transactions are being successfully transmitted," the Centers for Medicare and Medicaid Services, or CMS, spokeswoman Julie Bataille said at a news briefing.

Previously, Bataille has said the majority of errors had been fixed in these transactions but had not defined either the current or past rate of mistakes.

She said the error rate has fallen, explaining that in the more than two months since October 1, HealthCare.gov could have experienced an error in as many as one in four transactions. Errors include forms not being generated, transmitting duplicate forms and of forms with technical data being passed incorrectly, she said.

Widespread errors in coverage could add to public complaints over the law's rollout and provide ammunition to Republican lawmakers who have campaigned all along to delay or replace the 2010 Affordable Care Act, commonly known as Obamacare.

"The new process put in place this week is making a difference. The enrollment files are getting better, but there is more work to do to ensure consumers are covered," Karen Ignani, the chief executive officer of insurance industry trade group, America's Health Insurance Plans (AHIP), said in a statement on Friday.

BACK-UP SYSTEM

Insurers are also working with CMS on testing a short-term back-up system for the government to pay insurers for the income-based subsidies that many individuals will qualify for on the new online exchanges. The permanent system was not built before the website opened for enrollment.

The glitch-ridden consumer end of the website held back enrollment during October, when fewer than 27,000 people enrolled through HealthCare.gov. The government set a November 30 deadline for repairs. On Sunday and Monday alone, 29,000 people signed up, sources familiar with the number said.

The enrollment growth has raised questions about how insurers will keep up if the applications have errors and whether consumers will think they are covered by an insurance policy when they are not.

For instance, Jason Alford, the director of individual and marketplace sales at Health First Health Plans in Rockledge, Florida, said in an interview this week that applications are still incorrectly displaying if the person is a smoker or a non-smoker, a factor that determines the premium price in the state.

CMS said that there is a technology team dedicated to fixing the issues with the transaction forms. The team is overseen by the general contractor on the project QSSI, a unit of UnitedHealth Group Inc.

In an unusual show of solidarity, AHIP, CMS and the Blue Cross Blue Shield Association - whose licensees are the largest players on the insurance exchanges - this week issued a joint statement to stress their efforts to fix "back end" problems on HealthCare.gov.

Daniel Durham, vice president for policy and regulatory affairs at AHIP, said this week that insurers will estimate how much they are owed, and submit that estimate to the government.

Once the permanent system is built, the government and insurers can reconcile the payments made with the plan data to "true up" payments, he said.

(Reporting by Caroline Humer in New York, David Morgan and Roberta Rampton in Washington; Editing by Michele Gershberg and Grant McCool)

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Comments (10)
Vult6468 wrote:
“The new process put in place this week is making a difference. The enrollment files are getting better, but there is more work to do to ensure consumers are covered,”

I am sure they realize that most of the enrollees want insurance effective January 1. I am sure …. well….

Dec 06, 2013 9:27pm EST  --  Report as abuse
stambo2001 wrote:
Wait for it, just wait for it. You know there will be a delay in the individual mandate or the mess will be so epic there will be no choice but to repeal. Seems there is nothing this administration touches that doesn’t implode.

Dec 07, 2013 9:22am EST  --  Report as abuse
AZreb wrote:
Suppose this were your bank or credit union and you are making your deposits regularly, thinking that those deposits would be credited to your account. BUT those deposits are not getting into your account due to glitches in the bank’s computer program.

You write checks, those checks bounce, your credit is ruined and you probably end up in court and/or bankrupt.

BUT – you are one of the one-in-ten whose accounts are totally screwed up and since it is ONLY 10% of account holders who are affected by the screw-ups, that is a reasonable number.

That is the way government looks at the problem, too. ONLY 10%!!!

Dec 07, 2013 10:36am EST  --  Report as abuse
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