HHS IG Increases Budget to Handle Obamacare Fraud

HHS IG Increases Budget to Handle Obamacare Fraud

The Office of the Inspector General (OIG) at the U.S. Department of Health and Human Services (HHS) requested a budget increase this year, some of which will be used in preparing for fraud among Obamacare programs, including the embattled insurance exchanges.

A spokesman for the HHS OIG told Breitbart News that only a portion of the budget increase will be used to deal with problems related to Affordable Care Act (ACA) programs such as the insurance marketplaces.

Donald White, the spokesman, said, “Our need for increase funding goes far beyond ACA programs and marketplace issues, although that is part of it.” 

White stopped short from telling Breitbart News specifically how much of the budget increase will be used to deal with ACA programs.

In the HHS IG office’s FY 2014 budget justification document, the HHS inspector general’s office pointed out that the implementation of new ACA programs “underscores the need for OIG audits and evaluations to identify and mitigate vulnerabilities, can help ensure that data systems supporting ACA programs are accurate and complete and comply with security and privacy rules, and identify opportunities to improve efficiencies in new programs and benefits.” 

“In addition to increasing its evaluative and audit capacity for all HHS programs, OIG will need to be prepared to respond to an overall increase in credible allegations of fraud in new ACA programs in the coming years,” it continued.

The HHS OIG oversight responsibilities are broken down into two categories. One is oversight of the more than 300 non-Centers for Medicare and Medicaid Services (CMS) programs, while the other is oversight of Medicare and Medicaid. 

According to the budget document prepared for lawmakers, the non-CMS programs are referred to as Public Health, Human Services, and Department-wide (PHHS). Oversight of PHHS programs includes Obamacare insurance marketplaces and other ACA programs.

In FY 2014, the HHS inspector general requested an estimated $19 million increase over its previous level of approximately $50 million to keep a watchful eye over Obamacare and other non-CMS programs. The $19 million budget expansion in FY 2014 marks about a 40 percent increase over former levels of funding, which have remained at about $50 million since FY 2010.

The $19 million increase is aimed at “ensuring the efficient and effective administration of vital public health and human services programs and focusing on key priority areas, including monitoring the implementation and operation of the new Marketplaces and other ACA programs; overseeing the management of cross-Departmental issues, such as grants and contracts, and IT security; and ensuring the safety the Nation’s domestic and imported food, drugs, biologics and medical devices.”

“The FY 2014 request will support OIG’s efforts to expand its capacity to analyze data, identify fraud trends, and determine the best approach for oversight for the PHHS programs,” the budget document states. 

With limited resources to oversee the Department’s more than 300 non-CMS programs, OIG must capitalize on new tools and capabilities for detecting problems and look to facilitate smarter, timelier data collection and analysis. OIG’s challenge is to target its resources on the most at-risk programs and adopt oversight approaches that are suited to analyzing increasingly complex and sophisticated programs and tailored to protect those programs from vulnerabilities. This will be essential in FY 2014 as the Marketplaces and related data and technology systems will be operational.

By law, the HHS inspector general devotes most of its efforts, about 80 percent, on protecting the integrity of Medicare and Medicaid programs and the benefit recipients. The remaining 20 percent of the efforts will now be spent on non-CMS programs such as the Obamacare health insurance exchanges.

The estimated $389 million the HHS IG requested for 2014 mark an increase of about $101 million from the previous level of funding. Of the $101 million, $19 will go to oversight of non-CMS programs and $82 to CMS oversight.

Non-CMS oversight will be funded at a level of $69 million in 2014. Meanwhile, CMS oversight will receive $320 million in funding.

Obamacare’s insurance exchange federal website has been riddled with problems since open enrollment began on October 1st.

Congressional investigators have found that the website is vulnerable to fraud and other security risks.

At a November 13 hearing on the insurance exchange website’s security held by the House Homeland Security Committee, Chairman Michael McCaul (R-TX) said in prepared remarks that the information entered into the website “is a tempting target for hackers, identity thieves and other malicious actors. We already have reported cases of hacks, fraudulent websites and documented security vulnerabilities in the system.”


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