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Tags: gao | health benefits | fraud | federal employees

GAO: Billions Wasted on Federal Employee Health Plan

By    |   Wednesday, 28 February 2024 12:13 PM EST

Fraudulent enrollees in the Federal Employees Health Benefits (FEHB) Program could be costing taxpayers up to $3 billion a year, according to a report from the Government Accountability Office (GAO).

According to the report, the Office of Personnel Management (OPM), which is responsible for the health insurance of 8 million federal workers and their family members, has never conducted an eligibility audit.

The cost of ineligible enrollees in the health benefits program has been estimated by OPM's Office of Inspector General to be between $250 million and $3 billion a year.

In fiscal year 2021, the FEHB program cost about $59 billion to operate, according to GAO.

Sen. Rick Scott, R-Fla., says that's unacceptable and he plans to introduce a bill next month that would mandate the OPM conduct member audits.

"OPM does not care about fraud, or they would do it. It's not that hard," Scott, who requested the GAO report, told Politico. "Companies do it all the time, and states do it all the time. It's real simple to put a program in place to do it, so if you don't do it, that means you support fraud."

An OPM spokesperson disputed Scott's claim that fraud is not a high priority and told the outlet that the agency "takes the integrity of the FEHB Program very seriously and is working diligently with agencies to address improper enrollments within the constraints of our resources from Congress."

According to Politico, the OPM relies on more than 160 government employment offices and more than 70 contracts with health insurers to verify the eligibility of FEHB members and has no plans to conduct an audit — which it claims would be too expensive — despite recommendations from the GAO to do so.

OPM told the outlet that the $120 million audit would come out of its budget while the enrolling agencies would accrue the savings. It is focused instead on a "fully funded, centralized enrollment system for FEHB that would address the issues underlying improper enrollments;" the agency would not comment on the funding status or implementation of such a system.

The state of Florida conducted a comprehensive audit on its health benefits plan during Scott's stint as governor in 2018 and found that approximately 3% of enrollees were ineligible. The state saw more than $20 million in savings a year as a result.

Nicole Wells

Nicole Wells, a Newsmax general assignment reporter covers news, politics, and culture. She is a National Newspaper Association award-winning journalist.

© 2024 Newsmax. All rights reserved.


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Fraudulent enrollees in the Federal Employees Health Benefits (FEHB) Program could be costing taxpayers up to $3 billion a year, according to a report from the Government Accountability Office (GAO).
gao, health benefits, fraud, federal employees
391
2024-13-28
Wednesday, 28 February 2024 12:13 PM
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