GOP calls for federal investigation into allegations against Vermont Health Connect contractor

Kaitlin Francis of Burlington told of the trouble she had signing up with Vermont Health Connect at a news conference held by Vermont Republicans on Wednesday at the Statehouse. Lt. Gov. Phil Scott is at left and House Minority leader Don Turner, R-Milton, is at right. Photo by Morgan True/VTDigger

Kaitlin Francis of Burlington told of the trouble she had signing up with Vermont Health Connect at a news conference held by Vermont Republicans on Wednesday at the Statehouse. Lt. Gov. Phil Scott is at left and House Minority Leader Don Turner, R-Milton, is at right. Photo by Morgan True/VTDigger

Republican leaders from both chambers of the Legislature are calling for a federal investigation into allegations that technology firm CGI defrauded the state.

In a letter sent Wednesday to U.S. Attorney Tristram Coffin, the lawmakers requested that his office investigate “whistleblower allegations” regarding a potentially “fraudulent software demonstration” in July.

Those allegations received national attention when they were featured in a Newsweek article on the troubled rollout of Vermont Health Connect, the state’s new health insurance market.

At the heart of the fraud allegation is whether CGI was able to demonstrate a live connection to the federal data hub, a key component of determining a person’s eligibility for coverage through Vermont Health Connect. The article alleges that the demonstration was faked.

Mark Larson, commissioner of the Department of Vermont Health Access (DVHA), has repeatedly said he believes CGI showed a live connection to the federal hub, but the anonymous source cited in the Newsweek article said “… the system was in no way operable during that demonstration.”

“If it was (CGI) that duped the state officials, we need to know that,” said Senate Minority Leader Joe Benning, R-Caledonia.

As a criminal defense attorney, he said, the evidence rises to the threshold where an investigation is warranted.

If the allegations are substantiated, Benning said that should result in prosecutions.

“CGI confirms that the demonstration conducted on July 26, 2013, included a live interface to the Federal Data Services Hub, with the real time sending and receiving of data,” CGI spokeswoman Linda Odorisio said in a statement.

Benning said the request for an investigation is not politically motivated and comes from a desire to ensure that Vermont isn’t being duped.

Scott joins call to delay VHC

Republican Lt. Gov. Phil Scott joined House Minority Leader Don Turner, R-Milton, and other members of the House Republican caucus who want Gov. Peter Shumlin to delay requiring anyone to purchase health coverage through Vermont Health Connect until 2016.

Calling for the delay is not about political ideology, Turner said, adding that Republicans are focused on improving access to affordable health care in Vermont.

“That isn’t happening because of this non-functioning system,” Turner said.

The governor has the opportunity to “push the pause button,” until the exchange is fully operational, Turner said, adding that would be the prudent move.

“I’m here today as a business owner,” Scott said. “As you know we are the only state in the union that has mandated employers with less than 50 employees to join the exchange.”

Scott said the small business requirement has presented him and other business owners with hard choices. The difficulty is choosing a plan through the exchange that works for all his employees, some of whom work seasonally.

Though keeping his company’s current health plan is not an option, Scott said it makes sense to delay the requirement on small businesses to give them more time to decide how to handle the transition.

“I think this IT system will eventually work,” Scott said. “The exchange could be beneficial in the future, but it’s not ready for prime time right now.”

Republicans want both the small business requirement, which is unique to Vermont because President Barack Obama pushed back the federal requirement, and the requirement that individuals buy health care through the exchange to be postponed.

“We would hope that the governor would look at this for individuals and businesses,” Turner said.

Asked if Vermont could delay the requirement that individuals purchase insurance without running afoul of the feds, Turner said he needed more information.

“We create the law, (and) we should be able to work with the governor to do it,” he said.

Five months after it launched, the state exchange website still lacks significant functionality, Turner said.

As evidence that it won’t be completed in a reasonable timeframe, Turner quoted a story from WCAX saying that Blue Cross Blue Shield of Vermont CEO Don George told lawmakers that the small business components wouldn’t be ready until August.

George said Wednesday he never gave a date for when the small business functionality would come online, and his testimony to lawmakers is being misrepresented.

“We’re not close enough to the overall project plan to give an estimate for when it would be completed,” he said. “Blue Cross does not have a date by when we think the exchange will be done.”

On Friday in testimony to Senate Finance, George said that BlueCross is ready to transition to the website whenever it’s ready. “If it’s August this year then it can occur then,” he said. “If the state asked us to continue our obligation to our businesses for more than one year we certainly would do that.”

Turner said later that he had not listened to George’s testimony, and said it was based on a media report. Turner said he will review the tape of George’s testimony, and if he got it wrong will apologize to him and correct it.

“I only put that in to show that it’s more than just Republicans who are concerned about this,” he said.

Turner said he hopes the focus will stay on Vermonters’ ongoing struggle to navigate the exchange.

Republicans were joined at the news conference by Burlington resident Kaitlin Francis, who spoke of the ongoing frustrations and uncertainty she has experienced in trying to purchase insurance through Vermont Health Connect.

“I’m here today as a concerned Vermonter who has had trouble getting health insurance. I’m not part of any political party and I don’t really have any agenda here today,” she said.

Francis said she is working two part-time jobs while applying to grad school, and went on VHAP after leaving a full-time position.

She said she suffers from multiple chronic diseases that require regular visits to specialists and multiple prescriptions.

Francis began the application process in November. Despite having designed websites for a living, she needed the help of a navigator to complete the application, she said.

After waiting several weeks for an invoice, she called VHC and was told her application had been withdrawn. She completed it again, only to later receive an email that she had signed up for the wrong plan and was eligible for a greater subsidy if she switched.

It took another month, but in January — despite never receiving an invoice — she was able to find out what her premium was and mailed a check.

The check was cashed, but Francis said she has yet to receive an insurance card or policy number.

Francis hasn’t postponed any doctor’s visits or been unable to fill a prescription, she said, but that could happen soon.

“Currently, I’ve paid a premium and I don’t have a policy number, so I don’t have insurance in the eyes of a doctor’s office,” she said.

In the event she needs to receive care before she’s issued a policy number, Francis said she’s confident she could get it covered retroactively, because her check is cashed, but it’s unclear how or when that would happen.

Shumlin says he will stay the course

Shumlin said Wednesday that the rollout of the exchange site is a disappointment, and his administration is working to fix it, but said it did not make sense to delay any of the purchasing requirements.

“My administration has exhibited extraordinary flexibility as we recognize the challenges of the website, to ensure that no Vermonter goes uninsured and business doesn’t have an undue challenge put upon them,” he said.

The 30,000 Vermonters who have bought insurance through Vermont Health Connect represent the highest enrollment in the U.S., he said.

Shumlin touted the thousands of new Vermonters on Medicaid and the thousands now receiving subsidies as well.

“Let’s not delay things that are working, let’s continue to take the website, take the Affordable Care Act and make them even better,” he said.

Direct enrollment has given small businesses access to the products offered through the exchange without having to use the website, Shumlin said.

It appeared that Shumlin said at one point in the news conference that Vermont would continue to allow insurers to direct enroll businesses for the rest of the year.

Asked to clarify what he meant, Shumlin said, “We said to the business community, ‘Look, we don’t want this to mess you up, so you can go buy exchange product from your insurer’ … when they buy their policy they’re not buying it for a few months or until the website works, they’re buying it for the full year.”

Asked if businesses will have the option to direct enroll for the rest of the year, Shumlin said they would.

“That’s my understanding; does anyone disagree with me on that?” he said looking around the room.

Afterward, aides said Shumlin had misunderstood the question and was referring to the fact that businesses that already directly enrolled would have coverage for the whole year.

Direct enrollment will continue to be an option until the website’s small business functionality comes online, they said.

It wouldn’t make sense for businesses to directly enroll once the website is working, because the insurers are not able to offer the full range of insurance products through direct enrollment, according to the governor’s staff.

It was unclear if businesses that would prefer to directly enroll once the website is functioning will have that option.

Editor’s note: We updated this story to include quotes from Don George’s on Friday and a clarification that the information Don Turner included in his press release was from WCAX, not actual testimony.

Morgan True

Comment Policy requires that all commenters identify themselves by their authentic first and last names. Initials, pseudonyms or screen names are not permissible.

No personal harrassment, abuse, or hate speech is permitted. Be succinct and to the point. Comments should be 1000 characters or fewer. If your comment is over 500 words, consider sending a commentary instead.

We personally review and moderate every comment that is posted here. This takes a lot of time; please consider donating to keep the conversation productive and informative.

The purpose of this policy is to encourage a civil discourse among readers who are willing to stand behind their identities and their comments. VTDigger has created a safe zone for readers who wish to engage in a thoughtful discussion on a range of subjects. We hope you join the conversation. If you have questions or concerns about our commenting platform, please review our Commenting FAQ.

Privacy policy
  • Wendy wilton

    “Asked if businesses will have the option to direct enroll for the rest of the year, Shumlin said they would.”

    Huh? The governor does not even know what his administration has mandated…and that participants need to sign up by March 1 in VHC! OMG!

  • Bob Stannard

    Benning said the request for an investigation is not politically motivated and comes from a desire to ensure that Vermont isn’t being duped.

    Uh huh…

  • Doug Spaulding

    Well I believe we are being duped (more like being outright lied to) and the reason for that is, of course, politically motivated. Do you see that Bob or do you just see it the “other” way?

    • Bob Stannard

      Whenever I see politicians holding a press conference on anything, it’s political. The smart money is to not saying anything about the politics.

      Sen. Benning offered the comment that their actions weren’t political. You would have to be pretty naïve to believe that to be true.

      • Doug Spaulding

        You know what I was getting at Bob. Had that comment been made by any one of many – and some say too many – representing the majority party – your comment would never have been written in the first place! Right? Am I right?

        • Bob Stannard

          I stand by my comments. It should not be news that both parties play politics.

          In my life experience in this business whenever a politician from any party has to say that this is not political, then it’s pretty much a given that it is political.

          If you don’t think that the opposing party, in this case the Republicans, both nationally and now here in Vermont, are trying to use the rough roll-out to their political advantage, then you are naïve.

  • Ron Jacobs

    The basic problem is privatization here. If the state had hired its own people to do the site, there would have been more control. Anyone who thinks the request for an investigation is not motivated at all by politics is lying to themselves. As for the actual program (not the website) it’s working quite well!

    • Paul Washburn

      I am, and it has been 2 weeks today, still awaiting a finalization of what the state’s contribution will be towards my wife’s individual policy. When I first completed the application for her I inadvertently skipped over the financial assistance section and when I saw what the monthly premium was going to be for her I realized I must have made an error somewhere. It was in reviewing some notes that I had made that I realized I should have gone into that financial assistance section but, in trying to get back to it, I could not find a way to do it so I made a phone call to them and the first person I spoke to had absolutely no clue about the error I had made on the financial benefit section so she said she would have somebody else call me which, the next day, they did. This person knew a little more and did tell me that there is no way to go back into a section if you missed it or skipped over it on your first time through so she took all my wife’s information again and this time manually input it and upon completion she said I should hear from them in a week at the latest. Well it’s been 2 weeks and no word and I’ve made my follow-ups and I’m still waiting to hear back from them. They are just as disorganized now as they were 3 months ago and I believe Shumlin has washed his hands of it and expects his hired man Larson to run the ship all by his lonesome – as well he really should – but he isn’t because he is incapable. It is a mess and should be shut down and completely reorganized with a new date of readiness set for sometime in 2016.

  • David Healy

    As part owner of an under-50 employee business, I take issue with Lt.Gov. Scott’s proposal of delaying the requirement. We have already been through two iterations of getting all of our employees enrolled in plans.

    To re-enroll a third time would be a disruptive waste of our time and our employees’ time. The temporary solution we now have with Blue Cross is very workable. Most of the plans available from Blue Cross were ones that the employees had originally chosen.

    This whole experience from a business perspective is reason enough to support and move forward with the single payer system. We want to run and grow a consulting business, not be mired in supplying health insurance which we have no expertise.

  • Jamie Carter

    The state was given nearly 200 million to set up the exchange, and it still doesn’t work properly. I think an investigation is warranted and is it politically motivated? To a degree, but only because the left wants everything swept under the rug and to pretend it’s all great. It isn’t and a lot of the public’s money has been spent… any sane person would want to know how and if it was legit. Nothing in the request for and investigation would affect the implementation of VHC so yes, opposing this investigation is pure politics and the left simply opposing a reasonable request because it was initiated by the right.

    • Bob Zeliff

      You mean to say that a contractor was given a lot of money to do a job …and screwed it up.

      Yet again..big business, the darling of the Republicans, fails to deliver.

      I love it that the republicans are calling fraud.

      • Jonathan Willson

        Republicans don’t trust big business automatically. Generally, Republicans prefer the private sector because competition spurs innovation and punishes incompetence. When a private company has an exclusive contract with the government though, that competition is eliminated. Consumers then can’t hold the company accountable directly, and instead rely on elected officials to do so.

        It isn’t inconsistent of the Republicans to call fraud on this. I think both parties should really take a hard look at this. This exchange is uncharted territory and deserves as much constructive criticism as lawmakers and citizens can muster. Unfortunately, the Democrats can’t (or won’t) admit this thing is a flop because of the potential electoral consequences.

    • Doug Spaulding

      You could not have stated that any clearer Jamie. Your comment should end any further comments (after mine that is) on this article as there is nothing left to say!

  • Dave Bellini

    If the republicans squandered hundreds of millions of dollars on something that didn’t work, the Governor would be swinging from a neon chandelier with a bull horn calling a press conference. He would be screaming: “It makes my blood boil!!” He would be vanguard of thrift and demand an inquisition. The press conference may be part politics but it’s tame compared to the master thespian.

  • Ron Pulcer

    The first “healthcare exchange” was the FEHB (Federal Employees Benefit Plan), which started in 1960.

    “The government originally proposed a system that would revolve around a dominant government-directed plan, but unions and employee associations, which had sponsored their own plans, protested. Reflecting the political pressure thus created, the Congress modified the Executive Branch proposal and all existing plans were “grandfathered” into the program.”

    IMHO, the “idea” of applying the FEHB-like healthcare marketplace (FEHB covered Federal Employees, plus members of Congress and their staffs) to the general U.S. population could have been built upon the existing OPM agency and systems (U.S. Office of Personnel Management).

    I agree that the VT Legislature should consider whether to extend the enrollment period until they system bugs are worked out. But I also think that this press conference is “political”. Healthcare policy has been “political” in America for decades.

    Had Rep. Turner’s and Lt. Gov. Scott’s colleagues in the U.S. Congress not made such a “political” game out of healthcare reform debate over the past several years, maybe the PPACA law would have been better structured for the American People, and at a much lower price tag.

    If so, maybe each state would not be required to either build their own website, or utilize a new federal website. If so, Federal and state governments would not need to hire so many companies like CGI, et al and spend $Millions of tax dollars…

    Maybe if Congress (Republicans and Democrats) were not fighting each other constantly, they might have realized that they could have built a public-facing website / web app, that talked with the back-end systems that OPM (U.S. Office of Personnel Management) was already using.

    The OPM Federal Employee Health Benefit marketplace is “still” in use for Federal employees today!!!

    The exception “was” / “is now not” Congress and their staffs. That is because Speaker John Boehner lobbied to move themselves from FEHB to new PPACA federal exchange, in order to get premium “subsidies” for their staffs. But later, Speaker Boehner, wanted to remove Congress and staff from PPACA federal exchange during government shutdown. Now it seems that Congress and staffs are back on FEHB, but with PPACA-like subsidies. Now, that’s “politics”!

    Maybe if Speaker Boehner and his cronies weren’t playing politics with healthcare, maybe Democrats and Republicans would have “realized” that they “could” have built the new exchange for citizens on top of the already functioning OPM-based systems!!!

    The saga keeps on continuing. Stay tuned to VTDigger for more status updates …

  • Pat Whitley

    Bob Zeliff,
    The CONTRACTOR was hired by THE SHUMLIN ADMINISTATION driven board. It is their responsibility. As a general contractor, I am ultimately responsible for who I hire and how they perform. So should the state be with our money. The republican party here cannot stop or do anything from such a minority position. In our ONE party state, there is only one to blame for all of this. Vermont democrats would be far more successful if they took input from the minority party, remember Shumlin only one by roughly 3000 votes. NOT A MANDATE. Vt democratic party motto should be “don’t bother me with the facts , my minds made up”. Our legislature has an infantile rush to be first nationally on anything. You can choose to abort, choose to die by physician, smoke pot, rescued from heroin, but there is no way in hell they are going to allow you free choice in how you buy health care. Shumlin said, “we have the highest per capita enrollment in the country” of course, its not legal for a individual or business under fifty to buy it anywhere else. does he think we are that dumb? Its a joke .

    • Jason Farrell

      Peter Shumlin won his initial election to the Governor’s office by 4,331 votes in 2010, and then in 2012 he won by 59,809 votes, more than 20 percentage points than his rival. That’s a mandate.

      • Jamie Carter

        Oh Please with the mandate stuff… no election is ever a mandate… ever.

        Shumlin won a sweeping victory in his second term in part because he had moved to the right and become more moderate and dropped his extreme leftist ways on all but a few things. And secondly and most importantly because Brock was a terrible candidate who ran an even worse campaign. I’m not sure who the campaign manager was but I hope they retired.

        • Craig Powers

          4331 votes in 2010 is not a mandate. It was mostly votes delivered by the lefty Progressive Party for his promise of single payer. They were then sorry they voted him in when he veered right.

        • Kelly Cummings

          Uhmm, I believe that was Darcie Johnston. Someone please correct me if I’m wrong.

      • Doug Spaulding

        And, tragically, a huge mistake.

      • David Dempsey

        Shame on you Pat for your rough estimate of Shumlins margin of victory over Brian Dubie being off by around 1,300 votes, as Bob was so quick to point out. Good job Bob for pointing that out. Those extra votes turned a horse race into a landslide win for Shumlin.

        • Jason Farrell

          “In our ONE party state, there is only one to blame for all of this. Vermont democrats would be far more successful if they took input from the minority party, remember Shumlin only one by roughly 3000 votes. NOT A MANDATE. Vt democratic party motto should be “don’t bother me with the facts , my minds made up”..

          I read nothing in that comment referring to the “victory over Brian Dubie” that you’ve snarkily tried to append to Pat’s post. What I found most silly about Pat’s statement though, was that Pat lamented Democrats for their lack of “facts” and made up minds. FACT: Peter Shumlin moped up his Republican opponent in 2012 far exceeding the much closer margin in his inaugural run. The Governor’s twenty-plus percentage point victory in 2012 followed the Governor’s signing of Act 48 into law in 2011, not exactly a lurch to the right.
          It appears that you many suffer from the same affliction as Pat and refuse to accept that the passage of Act 48 was supported by a very large majority of Vermonters. That’s a mandate.

          So David, f you have different facts, I’m one Democrat that would entertain them and allow for a change of mind. But, if revisionist history is the best that opponents of Shumlin have in this election year, then I expect the near-monopoly Democrats have in Montpelier will continue.

          • David Dempsey

            I’m not sure if your entire comment was addressed to me. I didn’t talk about anything you mentioned except your last paragraph. I agree that Shumlins trouncing of Randy Brock was a mandate. I thought you were meant the extra 1,331 votes made a big difference against Brian Dubie. Now I know that you didn’t mean that at all.
            I agree the better man won in 2012, and my comment was wrong. Also sorry for calling you Bob in my reply.

          • Jason Farrell
  • Kelly Cummings
Thanks for reporting an error with the story, "GOP calls for federal investigation into allegations against Vermont ..."