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HHS watchdogs to focus on PPACA, other health programs

By Allison Bell

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The U.S. Department of Health and Human Services Office of Inspector General needed 10 pages to list all of the Patient Protection and Affordable Care Act investigations it hopes to complete by Sept. 30.

The agency, an arm of the U.S. Department of Health and Human Services, included the list in an appendix to the 2014 HHS OIG work plan.

Congress created the agency to protect the integrity of HHS programs and program enrollees.

The agency will be reviewing work on many different PPACA programs this year, not just the health insurance exchange program.

Some of the PPACA-related reviews will focus on Medicaid expansion, controls at the troubled Pre-Existing Condition Insurance Plan program, and use of Consumer Operated and Oriented Plan startup loans.

Key areas of exchange program interest include payment accuracy, benefits eligibility determination systems, vendor contract management, and data security and privacy.

In the payment accuracy area, for example, the agency is already working on a report on how well exchanges keep consumers from using fraudulent information to get the new health insurance subsidy tax credits.

The agency is also is working to keep the PPACA risk corridor program and other insurer risk management programs from running into the same kinds of problems that have cropped up in the Medicare Part D prescription drug plan risk management programs.

Gloria Jarmon, the HHS OIG deputy inspector general for audit services, said in a video interview on the agency’s website that the agency is working with auditors at the U.S. Government Accountability Office, the Internal Revenue Service and state agencies.

Jarmon said investigators are studying PPACA exchange contracting.

“What did happen?” Jarmon asked. “What should have happened? What lessons can we learn?” 

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