Digitalization in Tennessee, USA, seems to have gone wrong: many people have been illegally denied Medicaid and other benefits due to errors in the automatic system.
The state uses the TennCare Connect system to determine the eligibility of low-income and disabled residents for discounts. This is stated in the ruling District Court, which was the result of a class action lawsuit filed in 2020 on behalf of 35 adults and children who were denied benefits.
The TennCare Connect system, created by Deloitte and other contractors, cost $400 million. The algorithm analyzes information about income and health to automatically determine the eligibility of applicants for the benefits program. In practice, however, the system often fails to upload relevant data, assigns benefits to the wrong people, and makes erroneous conclusions.
«When a participant is eligible for the state’s Medicaid program, he or she does not need luck, persistence, and hard-nosed lawyers to obtain such health coverage,» Judge Crenshaw said.
The system’s launch in 2019 was the result of years of state efforts to modernize Medicaid delivery and simplify enrollment requirements under the Affordable Care Act. Under the law, states must provide a single application and information collection process for residents to determine which of the many comprehensive health and disability programs they are eligible for. The court found that TennCare Connect failed to consider whether applicants were eligible for all available programs before terminating their benefits.
Deloitte was one of the main drivers of these changes. It has been awarded contracts to build the corresponding automated systems in more than 20 states. Advocacy groups have asked the Federal Trade Commission to investigate Deloitte’s actions in Texas, where they say thousands of residents were similarly wrongfully denied health benefits due to program errors.
Source: Gizmodo