OIG to investigate subsidies, security of insurance exchanges

Part of larger Affordable Care Act oversight effort

The Office of Inspector General is planning to beef up its oversight of the Affordable Care Act, keeping a close eye on subsidies and how the Department of Health and Human Services protects individuals' personal information, according to an OIG report.

The agency said in the report that it will be adding between five and 10 investigations specifically focused on the ACA this year.

The reviews addressing health insurance exchanges will emphasize whether HHS is:

  • spending taxpayer funds for their intended purposes;
  • providing the right people with the right benefits by reviewing exchange enrollment safeguards, eligibility verifications for tax credits;
  • managing and administering exchange programs effectively and efficiently; and
  • ensuring consumers' personal information is safe on both the federal and state exchanges by reviewing security controls for consumers' personally identifiable information.

The OIG also will work closely with HHS and other law enforcement agencies to continue monitoring cybersecurity threats and consumer fraud incidents. The agency will take any "appropriate investigative actions" if anything is found.

Although the agency is spending most of its attention on the exchanges, it does plan to address other ACA programs, including Medicaid expansion and services, Medicare payment and delivery reform, Medicare and Medicaid program integrity and public health programs, according to the report.  

The OIG's focus on cybersecurity comes after the breach of Anthem's database, which compromised information of almost 80 million current and former Anthem members, FiercHealthPayer previously reported. It also follows on the heels of an OIG report that said the Centers for Medicare & Medicaid Services within HHS did not adequately prepare for the launch of Healthcare.gov in 2013.

To learn more:
- here's the OIG report

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