Business is booming on Healthcare.gov, so much so that the federal government extended a key deadline by two days to accommodate more consumers looking to sign-up or re-enroll for health insurance online.
But Healthcare.gov is being too hastyand negligentin verifying the authenticity and documentation of all consumers signing up for insurance, says a new report from the General Accounting Office. From June through November, GAO staff members used a mystery shopping approach to sign up 12 consumers with completely made-up names, personal information and support documentation for healthcare coverage.
The mystery shopping took place mostly outside of the key dates on Healthcare.gov for 2017 open enrollment, which generally runs from Nov. 1 through Feb. 1. Instead the test sign-ups took place to enroll the 12 fictitious consumers in a health plan based on a major change in lifestyle such as adding coverage for a new spouse, changing jobs or other condition.
The GAO conducted the inquiry and wrote its follow-up report to comply with a congressional order to test the enrollment and consumer information verification capability and thoroughness of Healthcare.gov. In the process the results shows the verification needs to be tightened. Of the 12 fictitious consumers, nine were approved for coverage with an average monthly subsidy of about $1,600 to help pay for coverage.
Six of the applications were completed online and six applications were started on Healthcare.gov but completed by phone, the GAO says. Of the nine fictitious consumers approved, five of them were certified for coverage without having to submit any documentation and four more were approved with phony documentation, such as a bogus Social Security number, drivers license and income.
Consumers are required to submit support documents if asked by the federal government, but Healthcare.gov does not conduct widespread checks into the authenticity of those documents, the GAO says.
The GAO prepared its report as a follow-up on an earlier warning and series of eight actions that the Center for Medicare and Medicaid Services, which operates Healthcare.gov, recommended in March be implemented as better fraud prevention and eligibility verification measures.
Those recommendations include, for example, running more continual analysis on eligibility and verification data to spot potential incidents of fraud. The GAO and the Center for Medicare and Medicaid Services didnt say how big a problem fraud currently represents on Healthcare.gov. In a letter responding to the GAO, U.S. Department of Health and Human Services assistant secretary for education Jim Esquea wrote that the department continues to make ongoing improvements to strengthen program integrity efforts and marketplace controls.
While GAO questions the eligibility-verification process on the federal health exchange, traffic to Healthcare.gov remains brisk. More than 4 million people picked Obamacare plans in the 39 states that use the federal HealthCare.gov marketplace in the first six weeks of the 2017 sign-up period, according to Bloomberg. The figure includes 1.1 million new customers and 2.9 million renewals through Dec. 10, says the Centers for Medicare and Medicaid Services.
On Thursday online benefits enrollment topped 670,000 consumers for that day and as an all-time daily high and prompted the federal government to extend a key deadline on Friday for certain individuals such as Medicare enrollees through yesterday because of high demand.