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Tags: obamacare | audit | healthcare | aca | health insurance

Audit: Obamacare Lacks Proper Processes, Communication

Audit: Obamacare Lacks Proper Processes, Communication
(Photo by Joe Raedle/Getty Images)

By    |   Wednesday, 06 January 2016 02:45 PM EST

The federal government can't ensure that Obamacare tax credits went to people who actually paid their monthly premiums for the health insurance, a new audit finds.

The Centers for Medicare and Medicaid Services has been relying on insurance companies to keep track of the premiums, a process that's complicated by the lack of a system to let the government and health plan companies share some data, the audit by the Office of Inspector General for the Department of Health and Human Services finds

"Without effective processes for ensuring that [tax credits] are made on behalf of confirmed enrolled, federal funds may be at risk," the audit warns, adding that "there is a risk that funds were authored for payment to [qualified health plan] issuers in the incorrect amounts."

The audit released Wednesday finds CMS hasn't had an adequate process in place since 2014.

"Instead, CMS relied on each [qualified health plan] issuer to verify that enrollees paid their monthly premiums and to attest that [tax credit] information that the issuer reported on its template was accurate," the inspector general said.

The audit is a follow up to the inspector general's findings last year that CMS couldn't verify $2.8 billion in subsidies given out in the first four months of 2014, the Washington Free Beacon reports.  

Under the law, CMS is required to ensure that premium subsidies only go to people enrolled in a federal or state marketplace, and who pay their monthly premiums, the Free Beacon notes.

The audit finds that complicating matters was the fact that people who miss their first monthly premium are given a mandated three-month grace period before their insurance is canceled.

Those enrollees are supposed to pay back what they owe through their tax returns. But since there wasn't a computer system set up to let marketplaces share enrollment information in 2014, there was no way to verify if the money was paid back, the Free Beacon reports.

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The federal government can't ensure that Obamacare tax credits went to people who actually paid their monthly premiums for the health insurance, a new audit finds.
obamacare, audit, healthcare, aca, health insurance
325
2016-45-06
Wednesday, 06 January 2016 02:45 PM
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