Category: Investigations

The Supreme Court on March 23 will  weigh how far the government has to go to accommodate religiously affiliated employers that object to including contraception in workers’ insurance plans. The issues has been brewing since shortly after the Affordable Care Act was signed into law in 2010.

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The federal government should do more to prevent people from fraudulently obtaining health insurance subsidies under the Affordable Care Act, the U.S. Government Accountability Office said in testimony to the Senate Finance Committee.

The testimony, delivered on Thursday in person and in writing by GAO spokesman Seto Bagdoyan, caps an extensive investigation by the GAO which found that, as of last April, about 431,000 people were still allowed to receive subsidies for insurance purchased through the federal exchange in 2014 despite possible inconsistencies in their applications.

A four-year-old fight between the Catholic Church and the Obama administration reaches the Supreme Court on Wednesday, in a bishop’s challenge to the health-care law’s contraception requirements that could alter the boundaries of religious freedom.

Eight justices will weigh how far the government has to go to accommodate religiously affiliated employers that object to including contraception in workers’ insurance plans. The outcome could affect as many as a million Catholic nonprofit employees. The case comes after the court’s 2014 Hobby Lobby ruling that for-profit businesses could assert such objections.

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The failures of a dozen non­profit health insurance plans created by the Affordable Care Act could cost the government up to $1.2 billion, according to a harsh new congressional report that concludes federal officials ignored early warnings about the plans’ fragility and moved in too late as problems arose.

The report, released Thursday by a Senate investigations panel, says that the bulk of those loans are unlikely to be recovered, with some plans unable to pay “a substantial amount of money” they still owe doctors and hospitals for members’ care.

A Senate panel found that the government ignored warning signs that Obamacare co-op plans were a bad bet when it doled out $1.2 billion in taxpayer funds to them.

The report from the Senate Permanent Subcommittee on Investigations, released during a hearing Thursday, found that in 2014 the Department of Health and Human Services gave out loans to failed consumer-oriented and operated plans, called co-ops, despite clear warning signs they weren’t reliable.

The co-ops were created to spur more competition on the Obamacare exchanges. However, of the 23 taxpayer-funded co-ops, 12 have shut down.

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The Federal government wants to leave doctors and hospitals on the hook for medical bills unpaid by the failed ObamaCare co-ops.

A top official at the Centers for Medicare and Medicaid Services told Congress that the government, not medical providers, has the first right to any remaining co-op funds. This CMS policy ignores a 1993 U.S. Supreme Court decision that says the federal government is next to last in line for payment in insurance cases, and policyholders should come first.

Twelve of the 24 co-ops funded through the ACA have failed and are going through the liquidation process. At least 800,000 people have had to find other coverage after their co-op policies were cancelled.

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According to the GAO report, billions of dollars in Obamacare subsidies were paid out in 2014 to individuals with “unresolved inconsistencies” regarding their eligibility for coverage:

• As of April 2015, more than 431,000 applications — amounting to $1.7 billion in taxpayer subsidies — had unresolved paperwork discrepancies dating to 2014.

• Roughly 22,000 applications that may (or may not) have been filed by people serving prison sentences added up to another $68 million in subsidies. (Prisoners are not eligible for Obamacare coverage.) The Centers for Medicare and Medicaid is required to check a national database to verify an applicant is not incarcerated, but since the CMS learned that the data in the database wasn’t up to date, CMS’ new official policy is to — get this — take the applicant’s word as to his or her incarceration status.

• Another 35,000 applications with varying forms of inconsistency with their Social Security numbers received subsidies worth $154 million.

With billions in taxpayer dollars at stake, the Obama administration has taken a “passive” approach to identifying potential fraud involving the president’s health care law, nonpartisan congressional investigators say in a report released Wednesday.

While the Government Accountability Office stopped short of alleging widespread cheating in President Barack Obama’s signature program, investigators found that the administration has struggled to resolve eligibility questions affecting millions of initial applications and hundreds of thousands of consumers who were actually approved for benefits.

The agency administering the health law — the Centers for Medicaid and Medicare Services — “has assumed a passive approach to identifying and preventing fraud,” the GAO report said. In a formal written response, the administration agreed with eight GAO recommendations while maintaining that it applies “best practices” to fraud control.

A new report dives into the problem-plagued development of the ObamaCare website and finds repeated warning signs that went unheeded before its failed launch.

President Obama has called the launch of healthcare.gov a “well-documented disaster,” and a Department of Health and Human Services Inspector General report provides a new in-depth look at the problems and lessons learned.

The IG report finds that the Centers for Medicare and Medicaid Services, which oversees healthcare.gov, received 18 “documented warnings” of problems with the site’s construction between July 2011 and July 2013. But the warnings were either not communicated across the agency or not acted upon, the report says.

The ObamaCare health exchange in Colorado faced “numerous weaknesses” and had “inadequate security settings,” leaving the personal information of enrollees vulnerable, according to a new audit.

The inspector general for the Department of Health and Human Services publicly released its review of Connect for Health Colorado on Wednesday, revealing the exchange had inadequate security measures in place for more than a year.

The report, which reviewed information security controls as of November 2014, did not go into specifics of Connect for Health Colorado’s vulnerabilities because of the “sensitive nature of the information.”