Dive Brief:
- The Obama administration is taking a 'passive' approach to determining whether fraud was involved in the Affordable Care Act as nonpartisan congressional investigators find that eligibility questions have been left unanswered, affecting hundreds of thousands of consumers who were legally entitled to benefits, according to an Associated Press exclusive report.
- The Government Accountability Office released a report this morning that raised several red flags with regards to the system that verifies ACA eligibility.
- In 2014, 11 fictitious phone or online applicants were approved for federal subsidized coverage during undercover testing, the report said.
Dive Insight:
Because the administration does not track the results of the data services hub -- HealthCare.gov's electronic system that queries the federal agencies responsible for verifying applicants' personal details -- it "foregoes information that could suggest potential program issues or potential vulnerabilities to fraud, as well as information that might be useful for enhancing program management," the GAO report said.
GAO investigators found many inquiries in which the data hub could not confirm details, such as the citizenship of about 8.2 million applicants for the 2014 coverage year, and their analysis determined that months after the coverage year ended, 431,000 applications, involving $1.7 billion in taxpayer subsidies, still had unresolved paperwork issues.