• Medical providers considering lawsuits over issues with NCTracks

    By: Tenikka Smith

    Updated:

    CHARLOTTE, N.C. - Pediatric dentist Dr. David Moore has been practicing since 1988.

    For the first time in his career, he said, "I've had to take a $100,000 line of credit, personal line of credit, to keep my business going."

    Moore blames NCTracks, the state's digital Medicaid system.

    He's one of the latest medical providers to contact Eyewitness News and said the system has problems and they are not getting reimbursed for their services. 

    After weeks of waiting, Moore is finally expecting a payment.

    "We have $300,000 in outstanding claims.  They are sending a check for $27,000,"  Dr. Moore said, "We are told to be patient and that's frustrating."

    Now Moore and other medical providers are looking at their options to sue the state and the company that operates NCTracks.

    Raleigh attorney Knicole Emanuel specializes in Medicaid litigation and spoke to Channel 9 by phone today.

    She said, "The federal law is very specific as to what timely payments for Medicaid reimbursement is.  The agency must pay 90 percent of all clean claims from the practitioner within 30 days of the date of receipt."

    NCTracks launched July 1 and the last payout under the old system was June 20.

    Those still waiting for reimbursement are past the 30-day window, but Emanuel says the state may argue a different point. "The agency can definitely argue that if a taxonomy number is incorrect or if there were mistakes on the part of the provider that these were not clean claims."

    Emanuel said that means providers will have to prove they submitted correct information and the problem is with NCTracks.

    Moore said he just wants what he is owed before he's forced to take even more drastic measures.

    Moore also pointed out a state audit from May that found DHHS failed to fully test the NCTracks system and that the production testing process had flaws. 

    DHHS did respond to the state's concerns and recommendations before the launch of NCTracks. 

    Eyewitness News reached out to DHHS for a comment about the potential lawsuits and are still waiting to hear back.

    To read through the audit, visit: http://www.Ncauditor.Net/epsweb/reports/infosystems/isa-2013-4410.Pdf and for more on the federal law regarding timely Medicaid payments, visit: http://www.gpo.gov/fdsys/pkg/CFR-2011-title42-vol4/pdf/CFR-2011-title42-vol4-sec447-45.pdf

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