WASHINGTON, DC - Energy and Commerce Committee leaders today sent a letter to CMS Acting Administrator Andy Slavitt requesting details after several recent Treasury Inspector General for Tax Administration and HHS OIG reports found possible waste and mismanagement in CMS’ administration of Obamcare’s Advanced Premium Tax Credit (APTC) payments. The letter was signed by full committee Chairman Fred Upton (R-MI), Health Subcommittee Chairman Joseph Pitts (R-PA), and Oversight and Investigations Subcommittee Chairman Tim Murphy (R-PA).
The president’s health law created the APTC - a refundable tax credit - to help eligible individuals and families with low or moderate incomes pay for health insurance. Individuals receive the credit by meeting certain eligibility requirements, including annual household income. The credit is issued directly to the provider, lowering the individual’s monthly premium. CMS is responsible for approving all payments for the federal and state-based marketplaces.
“[I]t appears that CMS has been slow to implement permanent processes to ensure accurate APTC payments, and has either failed or refused to implement IG recommendations to improve data quality and oversight over the APTC payments" wrote Upton, Pitts, and Murphy. “CMS’ apparent mismanagement and lack of oversight has exposed taxpayer dollars to waste and fraud. CMS has not developed a permanent process for approving APTC payments and is currently using an interim process to approve financial assistance payments. CMS officials are pilot-testing an automated payment process, but that process is reportedly well behind schedule."
The leaders continue, “In the past few months, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has issued a couple of reports, which have been critical of CMS’ role in implementing and managing APTC payments. In its August 2015 report, the OIG revealed that CMS was unable to properly verify applicants’ eligibility for the program. For example, the OIG found several instances where social security numbers were not validated, citizenship and annual household income was not verified properly, and family size was not determined correctly."
The committee leaders are requesting a briefing be scheduled within the next two weeks, and that responses to several questions be answered in writing.
