Total Incompetent Government Let Anyone Sign Up With No Proof Of Anything
March 9, 2016
There is now yet another reason to be disgusted by the ongoing fiasco known as Obamacare: A new report from the Government Accountability Office has concluded that the federal government’s failure to properly monitor the eligibility of enrollees may have cost taxpayers billions in fraudulent payments.
The problem stems from the inability of the system used by the Centers for Medicare and Medicaid Services (CMS) to verify “inconsistencies” in the data it receives from the three agencies (IRS, DHS and SSA) responsible for determining the eligibility of applicants under the Patient Protection and Affordable Care Act (PPACA).
From the report:
“GAO found CMS did not have an effective process for resolving inconsistencies for individual applicants for the federal Health Insurance Marketplace (Marketplace). For example, according to GAO analysis of CMS data, about 431,000 applications from the 2014 enrollment period, with about $1.7 billion in associated subsidies for 2014, still had unresolved inconsistencies as of April 2015—several months after close of the coverage year. In addition, CMS did not resolve Social Security number inconsistencies for about 35,000 applications (with about $154 million in associated subsidies) or incarceration inconsistencies for about 22,000 applications (with about $68 million in associated subsidies).”
The report warned that these unresolved inconsistencies leave the CMS vulnerable to making fraudulent subsidy payments to ineligible enrollees.
The GAO went undercover to test the system; it created 12 fictitious phone and online applicants during 2014, 11 of which received payments throughout the year, “even though GAO sent fictitious documents, or no documents, to resolve application inconsistencies.”
These fake enrollees received around $30,000 in advance premium tax credits, as well as “eligibility for lower costs at time of payment.” The GAO noted that although the subsidies were paid to healthcare insurers and not directly to enrollees, “they nevertheless represent a benefit to [fraudulent] consumers and a cost to the government.”
No one minding the store
When the GAO looked at how the CMS monitors fraud, it found that the CMS relies on a document processing contractor to report on instances of possible fraud, while not requiring the contractor to have any viable fraud detection capability.
In other words, this is like hiring a blind policeman to catch speeding vehicles.