- Associated Press - Friday, April 18, 2014

Argus Leader, Sioux Falls, April 12, 2014

S.D. needs help in computer dispute

The computer upgrade designed to make South Dakota’s Medicaid billing system more useful and efficient is mired in legal disputes, entangled with a federal bureaucracy and stalled by a recalcitrant vendor.

Not what state officials had in mind in 2008 when they let the bid to replace the more than 30-year-old-computer system.

Six years and almost $62 million later, the upgrade is not even close to installation.

Someone, somewhere should be able to change this situation.

It sounds like an exaggeration, but state officials and lawmakers outline a maddening tangle of problems since the bid to build a new computer system was awarded to Client Network Services (CNSI) of Maryland in 2008. The modernized system would help officials better analyze spending data in order to find efficiencies in the Medicaid payment program.

The process is complicated by the involvement of the federal government through the Centers for Medicare and Medicaid Services (CMS) that manages the federal health programs. The agency is supposed to provide 90 percent of the funding for states to upgrade their Medicaid computer systems.

State officials say the federal government has amended its payment promise and changed its Medicaid billing requirements since the contract was awarded.

CNSI sued the state, and South Dakota has counter-sued in the dispute. The state has tried to fire the vendor, but the federal officials persuaded them to mediate with the firm instead.

Many states apparently have had similar experiences trying to modernize their Medicaid systems. Part of the issue is that each state pays and records data in different ways to reflect state policies.

Clearly, this is a complex problem. But it’s time we push harder to get our congressional delegation involved. The scope of the problem is bigger than South Dakota.

Medicaid costs are among the highest of all programs funded by state government. With the new health care law and the push to increase the number of people covered by Medicaid, there is renewed need for reporting, billing and analysis tools provided by an upgraded computer system.

Sens. Tim Johnson and John Thune and Rep. Kristi Noem should step into this fray and work to bring about a resolution.

Gov. Dennis Daugaard should make the request for their help and seek guidance from other states that have worked through this process.

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