The U.S. Government Accountability Office (GAO) says it has no way of knowing how much the Center for Consumer Information and Insurance Oversight (CCIIO) is really spending on staff salaries, polling, public relations or travel.
Getting any information about the Patient Protection and Affordable Care Act (PPACA) agency is difficult, and checking most information about CCIIO is even more difficult, because the Centers for Medicare & Medicaid Systems (CMS) uses the same HIGLAS accounting system to manage its own operations and CCIIO’s operations.
Beryl Davis, a GAO director, writes about the agency’s concerns about CCIIO’s records in a report about GAO efforts to understand CCIIO. The GAO is a non-partisan congressional investigation agency.
CCIIO is a division of CMS, which is, in turn, a division of the U.S. Department of Health and Human Services (HHS). CCIIO is the agency in charge of the public exchange system, private health insurance rate reviews, and other PPACA-related HHS activities that affect the private health insurance market.
In some cases, CMS can provide CCIIO-only information, but, in most cases, it has to use “ad hoc, largely manual procedures” to get CCIIO information out of the HIGLAS system, and it is unable to provide general summary information that investigators could use to separate CCIIO information from non-CCIIO information, Davis says.
Because of those challenges, getting basic CCIIO spending information “often required an extended period of time” and, “in some cases, several months,” Davis writes.
GAO investigators could verify some CCIIO information, such as the fact that CCIIO hopes to collect $200 million in exchange fee user revenue in 2014. The investigators could also verify that CCIIO expects to spend $19 million on salaries for the fiscal year ending Sept. 30.
But GAO investigators could not consistently verify the reliability of reports on what CCIIO has actually spent. To get information about HHS and CMS employees reassigned to CCIIO, GAO investigators had to depend on “personal recollection unsupported by documentary evidence,” Davis says.
The GAO says CMS should come up with better systems and standard procedures for responding to data calls from Congress and from oversight agencies.
HHS officials told the GAO investigators that they did give the GAO data that investigators could use to check the CCIIO information supplied by CMS.
The GAO argues that it could get good verification information only for CCIIO-only appropriation accounts, not for any appropriation accounts used to pay for both CCIIO and non-CCIIO activities.