Florida's $308 Million Medicaid Computer System Fouls Up


The state of Florida has had to send out $44 million in emergency payments to over 5,600 Medicaid providers who have not been reimbursed for over a month due to computer problems, the Tampa Tribune reports.

It appears that Florida's new $308 million Medicaid computer system (covering its development and operations over 5 years) that went live on the 26th of June continues to reject a significant number of on-line claims for reimbursements, often stating that the provider wasn't authorized for payment. Promises to fix the problems made two weeks ago are still unfulfilled.

According to the Tribune story, "After filling out a claim and trying to submit it on the computer, many were told they didn't have billing authorization or their client wasn't eligible for Medicaid. Often, when the claim was accepted and they tried to open it later, they were told it did not exist. Then, if they tried to resubmit the claim, it was rejected as a duplicate."

One of the major requirements of new system reportedly was to allow for the processing of on-line reimbursement claims.

Initially, Florida Medicaid officials blamed users for the problem, saying that the system was complex and they just didn't know how to use it. However, the officials now acknowledge that there are "coding problems."

So far, Florida officials haven't used the old chestnut, "All systems of this complexity have teething problems" - at least not yet.


Risk Factor

IEEE Spectrum's risk analysis blog, featuring daily news, updates and analysis on computing and IT projects, software and systems failures, successes and innovations, security threats, and more.

Robert Charette
Spotsylvania, Va.
Willie D. Jones
New York City