HHS Works Through Paperwork Backlog of ACA Applicant Verifications

August 6, 2014 DATAMARK

GAO investigation finds applicants can easily falsify information to get taxpayer subsidies

The U.S. Department of Health and Human Services is working its way through a paperwork logjam of more than 1 million Affordable Care Act applications that require additional verification.

FoxNews.com reports that as of the middle of July, HHS has processed 650,000 of the 1.2 million applications that had inconsistencies in the information supplied by applicants. Most of the cases involve proof of citizenship, income and employer information.

Verification of the information is essential, as applicants are counting on taxpayer subsidies to help them pay for health plan premiums.

“We are working with consumers every day to make sure individuals and families get the tax credits and coverage they deserve and that no one received a benefit they shouldn’t,” said HHS spokesman Ben Wakana in the FoxNews.com article.

About 83 percent of people who applied for health care coverage were considered eligible for subsidies totaling $10 billion in the first year of the program, according to the Kaiser Family Foundation.

HHS has internal controls in place to verify applicants’ identity and income. But those controls were put in doubt after the Government Accountability Office revealed it had tested the system by submitting applications using fake documents.

For 11 or these 12 falsified applications, GAO was able to obtain subsidized health care coverage.

The GAO also conducted and undercover test of the ACA’s in-person assistance program, curious to see if the in-person assisters would encourage applicants to falsify income to qualify for subsidies. Interestingly, the GAO investigation didn’t make much ground–investigators were unable to even obtain in-person assistance in five of six attempts. Undercover investigators did connect with one in-person assistant, who correctly advised that the applicant’s income would not qualify for a subsidy.


The post HHS Works Through Paperwork Backlog of ACA Applicant Verifications appeared first on Outsourcing Insights.

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