Vermont’s troubled health insurance marketplace will soon undergo yet another round of scrutiny. And this newest audit will examine nearly every aspect of the year old program.
Vermont Health Connect – the official name of the state’s insurance exchange – has undergone plenty of inspection since it was launched last October. Most of the attention has focused on the technological glitches and managerial shortcomings that led to a rocky rollout for the troubled program.
But a new examination will test its performance on everything from the quality of the advice from people manning the call center, to the adequacy of the security systems that protect consumers’ data.
A new examination will test [the exchange's] performance on everything from the quality of the advice from people manning the call center, to the adequacy of the security systems that protect consumers' 2019 data.
“I think most of it’s the functioning of the exchange, in terms of its program integrity, security … internal controls, in terms of eligibility determination, and operating procedures for accurate enrollment and compliance with regulations,” says Harry Chen, secretary of the Agency of Human Services.
Chen says the “program integrity audit” is part of an annual reckoning required by the federal government. Chen’s agency launched a search for a contractor to perform the audit late last month.
Chen says federal regulators want to make sure state-based insurance exchanges do an accurate job determining benefits levels for low-income customers. And he says the Centers for Medicaid and Medicare Services also wants to verify that Vermont is adhering to the federal rules governing these state programs.
Vermont has spent more than $70 million on the exchange so far.
“I think audits in general absolutely do provide that opportunity, in terms of ensuring you have the appropriate compliance, the appropriate internal controls … basically that it’s working as it was intended to work,” Chen says.
The Shumlin administration has come under heavy fire for the technological problems that have plagued Vermont Health Connect since its launch. Administration officials last month took the Vermont Health Connect website offline, so it could rectify security issues.
Chen says the site is on pace to be back online well before the open enrollment period begins on Nov. 15.
“As least by the reports I get, we should be up probably within the next couple weeks,” Chen says.
The audit will begin Jan. 3, and its findings are due by the middle of March.
