Tags: Healthcare Reform | Supreme Court | Office of Inspector General | obamacare | subsidy | John Boehner

Report: Govt Can't Verify Accuracy of Obamacare Subsidy Payments

By    |   Wednesday, 17 Jun 2015 11:16 AM

The Office of Inspector General has discovered the Centers for Medicare and Medicaid Services (CMS) cannot verify the accuracy of almost $3 billion in subsidies for Obamacare customers paid to insurance companies in 2014.

The OIG's report says the failure to verify the payments were made properly puts "a significant amount of Federal funds are at risk."

The OIG found the problem existed between January and April 2014, and the root cause was due to a lack of internal controls.

"We recommended that CMS correct these internal control deficiencies by requiring its Office of the Actuary to review and validate QHP issuers' actuarial support for index rates that CMS identifies as outliers, implementing computerized systems to maintain confirmed enrollee and payment information so that CMS does not have to rely on QHP issuers' attestations in calculating payments, implementing a computerized system so State marketplaces can submit enrollee eligibility data, following its guidance for calculating estimated advance CSR payments, and developing interim reconciliation procedures to address potentially inappropriate CSR payments," the OIG report suggests.

House Speaker John Boehner said Tuesday the Obamacare system is "fundamentally broken" and lawmakers are working to come up with alternative programs to replace it.

"We're moving forward on legislation to bring reform and innovation to our healthcare system. Obamacare is fundamentally broken," Boehner said. "Americans can't afford it, and so the House is going to take action this week on solutions that will lower costs and expand access to quality health care."

The future of Obamacare is in the hands of the Supreme Court, which is deciding whether the law is invalid because of a four-word phrase included in it.

Should the high court decide to strike down the law, the White House does not have a backup plan to replace it and continue health coverage for the millions of Americans who could be affected by the decision.

Last week, meanwhile, the Treasury's inspector general said the IRS has no way to verify whether people who receive Obamacare subsidies actually qualify for them.

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The Office of Inspector General has discovered the Centers for Medicare and Medicaid Services (CMS) cannot verify the accuracy of almost $3 billion in subsidies for Obamacare customers paid to insurance companies in 2014.
Office of Inspector General, obamacare, subsidy, John Boehner
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2015-16-17
Wednesday, 17 Jun 2015 11:16 AM
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