Government Sends Obamacare Payments Without Verification

Dec 2014
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Just more evidence of another federal government disaster.


The Centers for Medicare and Medicaid Services (CMS) does not have adequate procedures in place to ensure tax credit payments were properly sent to enrollees as required by federal law, according to a new report by the Health and Human Services Office of Inspector General (HHS OIG).

The report marks the eighth time in less than a year that a government watchdog has raised concerns over the federal government’s ability to properly administer and monitor Obamacare.

As HHS OIG noted, CMS has “sole responsibility” for ensuring that tax credits were properly distributed to paying enrollees. Following this confirmation, the IRS is then responsible for reconciling tax credits with an enrollees' tax returns.

To meet this responsibility, CMS relied entirely on data from health insurers to verify whether enrollees had paid their premiums and were eligible. Unfortunately, this data was insufficient - insurers provided payment information on an aggregate rather than enrollee-by-enrollee basis, making verification all but impossible.

Insufficient data and poor verification processes meant that CMS was not even able to determine whether improper payments had been returned:

"CMS had not yet established computer systems to enable marketplaces to share confirmed enrollment data; therefore, CMS did not verify that QHP issuers were returning APTC overpayments to Treasury."​

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Government Sends Obamacare Payments Without Verification | Americans for Tax Reform