In a formal complaint filed January 31, the National Health Law Program (NHeLP), the Electronic Privacy Information Center (EPIC), and Upturn urge the Federal Trade Commission (FTC) to investigate Deloitte due to inaccurate and unreliable Medicaid eligibility determinations resulting from the use of the company’s automated software in Texas.
Errors in Deloitte’s Texas Integrated Eligibility Redesign System (TIERS) are jeopardizing essential health care access for hundreds of thousands of people in Texas who rely on Medicaid for health care coverage.
Deloitte provides Medicaid eligibility software to at least 20 states, including Texas. For at least the last 10 years, Deloitte systems across the country have had similar errors with the same dangerous result for people who depend on Medicaid: lost coverage. Litigation in Tennessee revealed that, in 2019, a programming error in the Deloitte-built system was causing newborn babies to lose Medicaid coverage because the software was not linking them to their mothers. The same problem is now happening in Texas, causing infants to go without essential health care.
This harm is even more acute in light of the nationwide Medicaid “unwinding” process, when an unprecedented number of people are undergoing Medicaid redeterminations following the end of the COVID-19 Public Health Emergency. Even when redeterminations were paused from 2020 to 2023, Deloitte did not address all of the existing, known problems with their software.
In a letter to the Texas Health and Human Services Commissioner, staff working with TIERS identified over 20 active, system problems, “each of which has either caused or is slated to cause disruptions in coverage.”
Our complaint today calls on the FTC to investigate Deloitte’s business practices, pause the use of TIERS, make public the details about how TIERS is programmed, and require Deloitte to create a comprehensive risk mitigation strategy to protect people in Texas from losing health care coverage.
Deloitte takes taxpayer money to provide Medicaid eligibility software to 20 states, but the software is faulty, and Deloitte has known of numerous failures over the last decade.
“Deloitte takes taxpayer money to provide Medicaid eligibility software to 20 states, but the software is faulty, and Deloitte has known of numerous failures over the last decade. These flaws lead to people who are eligible for Medicaid losing coverage because of design and programming errors made by Deloitte,” said Sarah Grusin, Senior Attorney with the National Health Law Program. “Unlike Deloitte’s publicly traded clients, the victims of these failures are the children who grew up in foster care, people with disabilities, pregnant and postpartum people, and their newborn babies. Today’s complaint is on behalf of the millions of Medicaid beneficiaries in Texas who have no choice but to wade through Deloitte’s faulty system.”
“Automation in public benefits may seem like a neutral step to help administer important programs, but it can actually worsen the long-standing racial and economic inequities that already prevent people from getting the support they need,” said Emily Paul, Project Director at Upturn. “Badly designed and inadequately tested software can end up incorrectly denying thousands of people in an instant, especially people whose circumstances aren’t considered by the system, whether that’s because they don’t have a permanent address or a traditional family structure, or due to their immigration status.”
“Deloitte has played fast and loose with Medicaid eligibility determinations, leaving hundreds of thousands of Texans in jeopardy,” said Grant Fergusson, Equal Justice Works Fellow at EPIC. “We should all expect better from the automated technologies around us: better testing, better oversight, and better outcomes. With today’s complaint, we urge the FTC to continue its work defending consumers from biased, inaccurate, and otherwise harmful automated technologies.”
