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Auditor: Md. health exchange documents redacted, withheld

ANNAPOLIS — Legislative auditors were thwarted from a meaningful review of the Maryland Health Benefit Exchange because of redactions or the withholding of key documents, according to a report by legislative auditors.

The 31-page report from the Office of Legislative Audits highlights results of a review of more than 14,500 pages of records covering the period between March 25, 2010, and Jan. 29, 2014.

“The documents did not provide any clear indication of the oversight and governance structure that may have existed to oversee and steer the [health exchange website] development process,” Thomas J. Barnickel III, legislative auditor, wrote in his report.

During testimony Thursday, Barnickel told the Joint Oversight Committee on the Maryland Health Benefit Exchange that his staff was charged with looking at documents released under the Maryland Public Information Act after requests by the media and others.

“We’re not sure we received all the documents shared with others,” Barnickel said. He added that typically, his auditors are privy to unaltered records.

“From an audit perspective, we see all the documents,” Barnickel said.

“We don’t have the complete story,” Barnickel told the committee. “There’s a lot we don’t know.”

Of his report, Barnickel told legislators that because of the enormous amount of documents to review over a short period, “there’s more information in the media than what’s in here.”

Much of what the auditor found useful were independent reports produced by BerryDunn, a contractor hired by the exchange to ensure that the site was meeting federally mandated requirements. Those reports have been previously made public.

Bicknell added that his office “could not determine who received the reports, addressed the risks and issues, and provided the state’s responses to the recommendations. Generally, we were unable to determine who the key decision-makers were and what decisions were attributable to them.”

Supporting documentation notes more than 600 emails containing state Department of Health and Mental Hygiene Secretary Dr. Joshua M. Sharfstein but none to or from Rebecca Pearce, the former director of the exchange. Pearce resigned after questions were raised about her taking a Caribbean vacation at the same time the state exchange was failing.

Barnickel’s audit was the main topic of the Joint Oversight Committee on the Maryland Health Benefit Exchange meeting Thursday afternoon.

State auditors also had trouble examining how the competitive bidding and procurement process for the development of the site was handled.

“Due to document redactions as well as a lack of documentation, we were unable to determine the propriety of the awards, including the basis for selecting successful vendors,” Bicknell wrote in the report.

Sharfstein told legislators that he believes his staff has provided everything to auditors and would continue to cooperate with state reviews and federal investigations.

“It’s my personal commitment,” Sharfstein said. “I follow up with auditors to make sure they are getting what they need.”

Sharfstein rebuffed claims that documents were withheld or otherwise not provided to state auditors.

“Just because they say they didn’t see it doesn’t mean it doesn’t exist,” Sharfstein said.

The state review of the health exchange is separate from an investigation that is being conducted by the inspector general of the U.S. Department of Health and Human Services, which was announced last month.

The Office of Legislative Audits is expected to begin a more in-depth performance audit starting this summer.

“The redactions we see now should not be any concern for the federal [investigation] or our audit,” Barnickel said.

Republicans in the General Assembly have repeatedly called for the legislature to hire an independent investigator with subpoena power to investigate the issue.

Democrats, who heavily outnumber Republicans in the General Assembly, have resisted those demands in a move some say is political because of the 2014 gubernatorial election and the fact that Lt. Gov. Anthony G. Brown was put in charge of the creation of the exchange. Brown is seen as the leading Democratic candidate for governor.

Earlier this year, the board that oversees the health exchange announced it had fired Fargo, N.D.-based Noridian Healthcare Solutions as the primary contractor after a teleconference meeting that was closed to the public and held late on a Sunday night. The board later hired Optum/QSSI, which is owned by United Healthcare — an insurance company that offers a plan through the state exchange and that donated more than $600,000 to the Democratic Governors Association while Gov. Martin O’Malley was chairman.

On Tuesday, O’Malley and other state officials announced that the state was replacing its troubled exchange website with a more successful site developed by Deloitte for Connecticut. The cost of the transition is believed to be as much as $50 million on top of the more than $100 million already spent on the site that opened on Oct. 1, 2013.