Washington, D.C. – The National Health Law Program (NHeLP), Electronic Privacy Information Center (EPIC), and Upturn have submitted additional information to the Federal Trade Commission (FTC) to supplement the January 31, 2024, complaint regarding Deloitte Consulting LLP’s operation of Medicaid eligibility systems. The systems have caused enrollees in Texas and across the country to lose critical health coverage, often resulting in significant financial and health problems.
The original complaint highlighted Deloitte’s unfair trade practices, particularly when errors are identified in automated Medicaid eligibility systems but Deloitte fails to take adequate steps to address these issues, or prevent those that are foreseeable. As a result, Medicaid enrollees face the unjust loss of critical health care and have no real way to avoid the harm caused by Deloitte’s errors.
This supplemental filing presents new evidence confirming an ongoing pattern of harm in Texas and across multiple states, including loss of coverage and denial of postpartum care. Deloitte’s failure to address issues quickly and prevent harm from known issues in Deloitte-operated systems does not benefit consumers or foster competition, but benefits Deloitte’s financial interests. The company frequently charges state Medicaid programs additional fees before making necessary corrections. These delays in resolving known issues result in both prolonged losses of coverage for low-income Medicaid enrollees and lingering, unresolved problems for state Medicaid agencies.
The new evidence includes testimony from a Deloitte manager during a federal trial in Florida, findings from another federal trial in Tennessee, a recent report from the Government Accountability Office (GAO), and additional case examples provided by attorneys in Texas and Colorado who work directly with impacted Medicaid enrollees. The supplemental evidence reveals Deloitte’s Medicaid eligibility systems are failing to: accurately determine disability-based eligibility tied to Supplemental Security Income (SSI) in multiple states; correctly calculate postpartum coverage; and recognize submitted documents through the online portal, resulting in wrongful loss of coverage. These issues have been observed in Texas, Tennessee, Michigan, Florida, Colorado, and beyond.
“Deloitte does not publish information about how its Medicaid eligibility systems work. Through NHeLP’s ongoing litigation against state Medicaid agencies, however, we have been able to pull back the curtain in some states,” says Sarah Grusin, Senior Attorney at the National Health Law Program. “When we dig in, we keep discovering repeated, serious problems in Deloitte-operated systems. We are calling on the FTC to investigate and take action to protect Medicaid enrollees, because it is clear that Deloitte is unwilling to fix these problems.”
“Deloitte has a pattern of building crucial software systems that are riddled with basic functionality errors, and then dragging their feet to fix their own mistakes,” says Emma Weil, Senior Policy Analyst at Upturn. “Simple components like document uploaders that work dependably in most other systems are instead unpredictable and misleading. Deloitte’s unreasonable handling of system errors impedes states like Texas’s ability to administer their own social safety net programs, harming the most vulnerable at a massive scale.”
“It’s alarming but not surprising to see more confirmation of how broken Deloitte’s Medicaid eligibility systems are,” says John Davisson, Director of Litigation at EPIC. “The idea of losing life-sustaining medical coverage because of shoddy software is hard to fathom, but that’s the tragic reality for many enrollees harmed by Deloitte’s systems. We renew our call for the FTC to take corrective action against Deloitte and to continue rooting out biased, inaccurate, and otherwise harmful automated technologies.”
For more information or to arrange an interview, please contact: Andy DiAntonio, Director of Communications at the National Health Law Program | [email protected].
Learn more about the NHeLP litigation referenced in the supplemental complaint:
Chianne D. et al v. Jason Weida, Middle District of Florida
A.M.C. v. Smith, Middle District of Tennessee
And learn more about NHeLP’s Fairness in Automated Decision-Making Systems work at www.healthlaw.org/algorithms.
Also read the KFF article mentioned in the complaint here, Errors in Deloitte-Run Medicaid Systems Can Cost Millions and Take Years To Fix, by Samantha Liss and Rachana Pradhan.
About the National Health Law Program (NHeLP)
The National Health Law Program (NHeLP) protects and improves access to health care for low-income and underserved people and works to advance health equity. We believe that everyone should have access to high quality, equitable health care and be able to achieve their own highest attainable standard of health. We enforce health care and civil rights laws; advocate for better federal and state laws and policies; train, support and partner with national, state and local health and civil rights advocates; and use strategic communications to achieve these goals.
About the Electronic Privacy Information Center (EPIC)
EPIC was established in 1994 to protect privacy, freedom of expression, and democratic values in the information age. Our mission is to secure the fundamental right to privacy in the digital age for all people through advocacy, research, and litigation.
About Upturn
Upturn advances equity and justice in the design, governance, and use of technology. We believe technology should advance justice, not amplify racial, economic, and social inequities. Without focused attention, technology can reinforce systemic injustices found everywhere in our society. We drive policy changes by combining rigorous research with deliberate advocacy. Our approach to technology and justice is informed by a broad range of perspectives and experiences, including computer science, social science, law, and policy. We strive to ground our work in community and lived experiences.
