NCTracks earns federal certification

RALEIGH — NCTracks, the claims payment system implemented by the North Carolina Department of Health and Human Services on July 1, 2013, has earned certification by the federal Centers for Medicare and Medicaid Services (CMS).

CMS found that NCTracks, the largest IT project in North Carolina’s history, meets the federal government’s stringent requirements for accurate and timely payment of claims for medical services submitted by health care providers.

dhhsThis certification will result in an infusion of about $19 million from CMS to the state because the federal government will now bear more of the cost of its operation. Retroactive to the July 1, 2013, go-live date, CMS will now cover 75 percent of NCTracks’ annual operating costs, instead of the 50 percent it has covered since the system went live. This results in approximately $19 million in additional federal funding to the state.

Overall, NCTracks is more efficient and less costly to operate than the previous system, and has been saving taxpayers about $3 million per month since its implementation on July 1, 2013.

DHHS leadership received a preliminary notification call of this certification on Friday and a formal notification is expected to follow within a week.

“We are thrilled with this news,” said DHHS Secretary Aldona Wos, MD. “This accomplishment represents tremendous dedication and commitment on the part of our team. We are also grateful for the North Carolina providers and the provider associations who have partnered with us during this roll-out.”

“After years of delays, successfully implementing and achieving certification for this system are important milestones for DHHS,” said Chief Information Officer Joe Cooper. “Some states work for years to reach certification on such large systems. To achieve certification in less than two years is a significant accomplishment.”

The department contracted with Computer Sciences Corporation (CSC) in 2008 to design and develop this claims payment system. The system experienced a number of implementation delays throughout the years. When NCTracks launched on July 1, 2013, it replaced a 35-year-old system and now allows providers to receive nearly real-time notice of the status of their claims for the first time.

NCTracks is the first multi-payer system in the nation and issues 50 payments per year to providers, instead of the 42 paydays a year made by the previous system. This means providers have more current access to their claims information and are being paid more often.

Since implementation, NCTracks has never missed a scheduled payment and has processed more than 360 million claims and paid more than $19 billion to providers.

In addition to implementing NCTracks, DHHS has been working with Truven Health Analytics to implement a new data warehouse, NC Analytics, which became accessible to users in November of 2013. It is also on the path to certification and has a final step to complete before being certified, which is anticipated later this year.

North Carolina Medicaid covers 1.9 million North Carolinians at an annual cost of $13 billion in combined state and federal funds.

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