Tags: Barack Obama | Healthcare Reform | obamacare | tighten | requirements | public | exchanges

White House Plans Test Program to Stop Obamacare Scammers

White House Plans Test Program to Stop Obamacare Scammers

(AP)

By    |   Tuesday, 06 September 2016 05:40 PM

The Obama administration said Tuesday that it was taking steps to tighten requirements for people signing up for Obamacare through the program's public exchanges outside of open enrollment periods.

"We are committed to making sure that special enrollment periods are available to those who are eligible for them, and equally committed to avoiding any misuse or abuse of special enrollment periods," the Department of Health and Human Services said in a release.

These steps include providing documentation to confirm whether Obamacare applicants are eligible to enroll in the program outside of the open enrollment periods and increased warnings to Healthcare.gov and other websites. Also, some special enrollment periods have been eliminated.

The agency is planning a pilot program next year that seeks to eliminate those who are scamming the system, Business Insider reports.

For example, those Americans facing special situations would enroll in Obamacare exchanges outside the general open enrollment period.

These would be people who have lost insurance paid by their employers or those who no longer are carried by their parents because they have turned 26 years old, according to the report.

However, HHS is concerned that those who do sign up during the special enrollment periods only do so when they are sick and need coverage.

Insurers cannot deny coverage to patients based on pre-existing conditions and, therefore, sick enrollees cannot be denied Obamacare coverage. This increases costs to insurers.

Obamacare is managed within HHS by the Centers for Medicare and Medicaid Services (CMS).

"We also noted the concerns we have heard about how these actions are affecting the exchange risk pools," according to the release. "Some have said that additional changes are needed to prevent individuals from misusing special enrollment periods to sign up for coverage only after they become sick."

CMS said that these steps have cut down some Obamacare abuse.

"In the seven weeks prior to implementation of the confirmation process, special enrollment period plan selections in 2016 were about the same as during the same weeks in 2015," the release said.

"In the seven weeks after implementation, special enrollment period plan selections in 2016 were almost 15 percent lower than during the same weeks last year, although why enrollments are falling in response to the new confirmation process is unclear."

CMS will be accepting comments on its plan through Sept. 20 before making final decisions, Business Insider reports.

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The Obama administration said Tuesday that it was taking steps to tighten requirements for people signing up for Obamacare through the program's public exchanges outside of open enrollment periods.
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Tuesday, 06 September 2016 05:40 PM
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