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Vermont Health Connect promises fixes after critical audits of health insurance exchange


MONTPELIER, Vermont — Although Gov. Peter Shumlin recently proclaimed the Vermont Health Connect a "totally different ballgame" in comparison to last year's performance, a House committee on Monday heard of several unresolved problems affecting the insurance exchange.

"There's a heck of a lot that's not fixed yet," said Rep. Anne Donahue, R-Northfield, a member of the House Health Care Committee. "It's a long, long way from saying 'Victory! The system's working now.'"

Cassandra Gekas, operations director for Vermont Health Connect, said staff members are working on a problem in which hundreds of people who paid their monthly premiums on time were canceled for nonpayment. Apparently, the cancellations were related to a five- to seven-day period it takes for the system to process end of the month payments.

Gekas and Lori Collins, deputy commissioner of the Department of Vermont Health Access, also responded to critical audits — one by state Auditor Doug Hoffer's office and another by the national accounting and consulting firm Grant Thornton.

Collins said Grant Thornton looked at calendar year 2014 and many of the problems it cited had been resolved since the review period ended 11 months ago.

"Fortunately ... we are in a far different place than we were when Grant Thornton conducted this audit," she said.

The Grant Thornton review faulted the state program for not having detailed, written procedures in place for many of its functions — something Gekas acknowledged Vermont Health Connect was still working on.

Hoffer's audit found that as of Oct. 30, the system had 121 "outstanding security weaknesses" of which three were high risk and 63 were moderate risk. But Gekas said the numbers fall "well within" the range deemed acceptable by the federal agency that oversees the exchanges.

Hoffer also found Collins' department gave contractors the go-ahead to do work without following the state's usual procedure for doing so. Gekas said the state was under pressure to get the system fully up and running, but she also promised to adhere to the policy in the future.

Vermont Health Connect was plagued with technical glitches and security problems after its launch Oct. 1, 2013. Shumlin announced last winter that the system had to automate by this fall its "change-of-circumstance" function, in which consumers report job changes, marriages and other life events that affect health insurance. The function was automated, prompting the governor's laudatory comments in mid-November.

Failing to get enrollments and changes automated likely would have increased pressure on Vermont to scrap the state exchange and join the federal one, something administration officials resisted. Administration Secretary Justin Johnson testified Monday that switching to the federal exchange would have brought hefty new costs and disruptions.

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