A federal lawsuit alleges that Deloitte Consulting’s Medicaid eligibility system in Florida incorrectly terminated postpartum coverage for eligible women and newborns, leaving some of the state’s most disadvantaged residents without access to crucial healthcare. The complaint focuses on the system’s continuous problems and how they affect thousands of Floridians.
The Case of Mandi Rokx
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Mandi Rokx, a new mother from Melrose, Florida, learned in mid-May 2023 that both her Medicaid coverage and that of her infant daughter Vernita will be canceled on May 31. This occurred despite a state statute requiring postpartum women to have continuous Medicaid coverage for 12 months. Rokx, despite adhering to all renewal requirements, was compelled to cover her daughter’s medical expenses herself and sought assistance from nonprofit health fairs.
Systemic Problems with Deloitte-Run Systems
The lawsuit contends that defects in Deloitte’s development and maintenance of Florida’s Medicaid eligibility system resulted in erroneous termination. Trial testimony revealed that a “defect” in the system failed to properly address postpartum mothers’ eligibility.
Harikumar Kallumkal, Deloitte’s managing director for Florida’s Medicaid system, stated that the business detected and resolved the issue by May 2024. Plaintiffs such as Rokx, on the other hand, claim that the problem persisted after this time period.
According to a report by the United States Government Accountability Office, other states that use Deloitte’s systems, including Texas, have documented similar problems, including the disenrollment of 100,000 eligible persons due to system faults.
Florida’s Medicaid Unwinding and Its Fallout
The problems in Florida worsened throughout the Medicaid “unwinding” process, which began after the pandemic-era coverage safeguards expired in March 2023. During this time, nearly 2 million Floridians, including children, lost their Medicaid eligibility.
State statistics predict that by March 2024, about 19,802 women will lose pregnancy-related coverage, but it’s unclear how many of these terminations were due to system flaws. Advocates argue that the true figure is greater since it excludes cases deleted due to “paperwork issues.”
Advocates and Lawmakers Speak Out
Patient groups, such as the Florida Health Justice Project, say that the state failed to fully inform affected persons about their right to appeal Medicaid termination decisions. They further claim that state authorities willfully continued with the unwinding process despite being aware of faults in the eligibility system.
According to Lynn Hearn, an attorney with the Florida Health Justice Project, “Florida’s Medicaid authorities knew from the beginning of the unraveling period that their system was not managing pregnant and postpartum Medicaid correctly, yet moved full steam ahead nevertheless. The mothers of this state deserve better from their government.”
Congressional leaders have blasted Deloitte and state governments for failing to address systemic flaws. Rep. Lloyd Doggett (D-Texas) termed the situation an “alarming and unacceptable waste of taxpayer dollars,” while Sen. Ron Wyden (D-Ore.) drew attention to “outdated and inaccurate eligibility systems” nationally.
Ongoing Litigation and Deloitte’s Role
The class-action case does not mention Deloitte, but it has called into question the firm’s involvement in establishing and operating Florida’s Medicaid system. Critics have chastised Deloitte, a prominent contractor in Medicaid eligibility systems around the US, for systemic failures that delay eligible patients’ access to healthcare.
The case’s outcome could impact Floridians like Rokx, potentially influencing the state’s future efforts to reform the system and guarantee qualified families receive their entitlement to coverage. As the trial progresses, patient activists maintain their call for accountability and structural reform.