The Government Accountability Office (GAO) released a report which concludes the Centers for Medicare and Medicaid Services (CMS) made no attempts to prevent various types of Obamacare fraud throughout 2014.
The GAO analyzed 2014 data from the Marketplace and federal agencies, interviewed CMS officials, and conducted undercover testing.
What they found is CMS doesn’t bother to look for fraud and there’s plenty of it. Ineligible applicants are receiving taxpayer-funded subsidies for Obamacare.
The program that was to be funded in part from eliminating waste and fraud is a place to go to commit waste and fraud.
Obamacare requires applicants for subsidies paid by taxpayers to go through an electronic system called “data services hub” which links to federal sources to verify consumer application information. Although it has a key role in the eligibility and enrollment process, CMS (Centers for Medicare & Medicaid Services) does not track or analyze outcomes – at all.
So, fraud is not picked up and enhancements cannot be made.
They don’t have a process that works to resolve inconsistencies for applicants. The GAO reported that in 2014, about 431,000 applicants with about $1.7 billion in subsidies had unresolved inconsistencies.
Social Security number inconsistencies are not resolved for 35,000 applicants (probably mostly illegals) with $154 million of tax-paid subsidies. There were prisoner inconsistencies for about 22,000 applicants with $68 million in subsidies.
Obviously people who are ineligible are receiving subsidies.
Undercover testing by GAO found 11 of 12 fake GAO phone or online applicants for 2014 received $30,000 in annual advance premium tax credits plus eligibility for lower costs of service. It wasn’t picked up throughout 2014. While you can’t generalize to the entire population, you certainly can assume Obamacare is like the wild west with taxpayer money being absconded by anyone with the inclination to do so.
CMS uses a contractor but doesn’t even bother to require the contractor to have any fraud detection capabilities.
What do they care? They’ll just steal more money from taxpayers.
CMS doesn’t perform any comprehensive fraud risk assessments either.