Want to lie about your age to a Patient Protection and Affordable Care Act (PPACA) public exchange, or help consumers jiggle their income to qualify for better premium subsidy tax credits?
Know that the cost of getting caught could be high.
The Center for Consumer Information & Insurance Oversight (CCIIO) — the agency that runs the PPACA exchange system for the U.S. Department of Health and Human Services (HHS) — has made a point of warning agents and brokers about the dangers of exchange fraud in a new draft document aimed at the insurers that might sell plans through the exchanges in 2016.
If adopted as written, the “draft letter to issuers” would apply directly to the insurers that sell qualified health plans (QHPs) through the exchanges managed by HHS. The letter could also influence the rules set by the states with state-based PPACA exchanges.
In the new draft letter, CCIIO officials have added a more detailed list of the agreements producers need to execute when they register to sell QHP coverage for the HHS exchange issuers.
CCIIO also has added a stern summary of the penalties for giving a public exchange inaccurate information.