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The Patient Protection and Affordable Care Act (PPACA) requires applicant information be verified to determine eligibility for enrollment or income-based subsidies. To implement this verification process, the Centers for Medicare & Medicaid Services (CMS) created an electronic system called the “data services hub” (data hub), which, among other things, provides a single link to federal sources, such as the Internal Revenue Service and the Social Security Administration, to verify consumer application information.
So all applicants are to be verified. What happened?
For example, according to GAO analysis of CMS data, about 431,000 applications from the 2014 enrollment period, with about $1.7 billion in associated subsidies for 2014, still had unresolved inconsistencies as of April 2015—several months after close of the coverage year. In addition, CMS did not resolve Social Security number inconsistencies for about 35,000 applications (with about $154 million in associated subsidies) or incarceration inconsistencies for about 22,000 applications (with about $68 million in associated subsidies).
Almost $2 billion dollars in claims are unresolved from about 500,000 possible fraudulent claims - from general fraud claims, social security number fraud, and people who are in jail.
During undercover testing, the federal Marketplace approved subsidized coverage under the act for 11 of 12 fictitious GAO phone or online applicants for 2014. The GAO applicants obtained a total of about $30,000 in annual advance premium tax credits, plus eligibility for lower costs at time of service.
Fraudulent claims were accepted at above a 90% rate.
So the GAO is strongly suggesting that they get a grip on the fraud.
I think the government is OK with the fraud, in that it does boost the participation number. The illegal immigrants are probably benefiting as well.
You wonder why medical costs continue to rise, the people who pay the taxes are underwriting all of the fraud, and all of the government waste, as well as the people who are receiving "free" health care.
If people are interested in REAL affordable health care, get the government out of the revenue stream and let people who intend to provide real services do the work.
The GAO outlines a problem, offers solutions and is then promptly ignored because fixing any flaws in the law would be tantamount to Republican orthodoxy. Better to find flaws and then run around claiming the law doesn't work instead of just fixing the problem. Love the logic.
There is always fraud in government programs....always!
You get what you accept. As long as we the people accept such fraud we will get it and more.
The government are the only ones who accept a bid on a project and then willingly, no gladly, pays more when a contractor demands it. Why even bother taking bids?
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