Become a digitalPLUS subscriber. 99¢ for 4 weeks.
NewsMarylandSun Investigates

Company helping fix Md. health exchange linked to firm selling policies

Healthcare IndustryInsuranceCareFirst BlueCross BlueShieldUnitedHealth Group Inc.Care Group Incorporated

When state leaders brought in a new company to help repair their troubled health care exchange, they went to one whose owner has a lot to gain from the sales of insurance plans under the Affordable Care Act.

The Columbia-based health care technology company Optum/QSSI is a subsidiary of UnitedHealth Group, which also owns one of the four insurers selling policies on Marylandhealthconnection.gov.

United Health Care Group spokesman Matt Stearns said Optum/QSSI operates separately from its insurance company. There is no interaction between the companies under the exchange contract, he said.

"Optum/QSSI is not involved in any policy determination or judgment related to the site or the exchange," Stearns said. "All we are doing is enhancing the stability and performance of the site. It is a distinct free-standing health services business."

State officials also saw no conflict of interest in hiring the firm on an emergency basis for a two-month, $4 million stint helping fix the online portal for the uninsured. Officials say the contract — largely funded with a new infusion of federal dollars — could be extended.

"The firm was picked because it is a top-tier technology firm with experience fixing the federal marketplace," said Dori Henry, a spokeswoman for the Maryland exchange.

"The firm can help us consider and implement a range of options," she said. "As with their federal work, Optum/QSSI takes steps to avoid conflicts of interest related to its corporate parent."

State officials have said one of those options could be shifting to the federal exchange — for which QSSI also was hired to build a data hub and later brought back to help fix that site after its botched Oct. 1 rollout.

QSSI will help the state's main contractor on the exchange, Noridian Healthcare Solutions, which also is owned by an insurance interest — BlueCross BlueShield of North Dakota, which is independent of CareFirst BlueCross BlueShield, another of the companies selling policies on Maryland's exchange.

Optum/QSSI officials did not return phone calls.

While Maryland officials see no conflicts, some federal lawmakers might.

Several Republicans wrote letters of concern to Obama administration officials when QSSI was first hired. They worried that the insurer would have an unfair advantage by accessing information not available to other insurers.

Meredith Cohn and Andrea K. Walker

Copyright © 2014, The Baltimore Sun
Related Content
Healthcare IndustryInsuranceCareFirst BlueCross BlueShieldUnitedHealth Group Inc.Care Group Incorporated
Comments
Loading