Watchdog: Not All Health Exchange Controls Were Effective In Confirming Subsidy Eligibility
According to the inspector general of the Department of Health and Human Services, some consumers who obtained coverage or subsidies through healthcare.gov may not actually have qualified. Also, the Centers for Medicare & Medicaid Services because of inconsistencies in the data, is delaying the release of information regarding how much health insurance companies will receive or be charged -- as a result of a health law provision -- to even out the risks of covering people who were previously uninsured.
The Wall Street Journal:
Audit Of Health Exchanges Finds Fault With Controls
Some consumers who got health coverage or subsidies through HealthCare.gov might not have been eligible to receive them last year because of deficiencies in the federal exchange’s internal controls, according to a government report likely to further stoke Republican criticism. Not all the internal controls were effective in determining if applicants were properly eligible for health insurance or subsidies, the Health and Human Services’ Office of Inspector General concluded in a report released Monday. It also found problems resolving inconsistencies between some applicants’ information and federal data. (Armour, 8/10)
Modern Healthcare:
Healthcare.gov Failed To Verify All Applicants' Eligibility
The federal marketplace for getting insurance under the Affordable Care Act lacked adequate controls for verifying citizenship status, income and family size to determine eligibility and subsidies, according to a new report. HHS' Office of Inspector General reviewed 90 applicants from the 2013 and 2014 enrollment periods. The report notes that the problems identified don't necessarily indicate that anyone was improperly enrolled or received subsidies they weren't eligible to receive. (Muchmore, 8/10)
Modern Healthcare:
CMS Delays Insurance Payout Data From ACA's Risk Corridors
The federal government has postponed the release of data that will show how much health insurance companies will receive or be charged under an Affordable Care Act program meant to mitigate the risk of taking on previously uninsured members. All health insurers that sold plans on the ACA's exchanges had to submit information on the risk corridors program by July 31. The CMS planned to publish data Aug. 14, but the agency pushed back the release to an unknown date because there were inconsistencies in the data. (Herman, 8/10)
