The Government Accountability Office warned Friday that gaps in ObamaCare are clearing the way for redundant payments and fraud.
The federal watchdog found that some people have duplicate coverage, meaning that they are enrolled both in Medicaid and in private coverage through the law’s marketplaces. The report said that means that the government could be incorrectly paying twice for someone’s coverage through both programs.
The report said the Centers for Medicare and Medicaid Services (CMS) has some checks in place but that they could be improved. GAO recommends that the administration establish a schedule for regular checks for duplicate coverage and develop a plan to monitor the effectiveness of those checks. As of July, CMS did not have regular checks for duplicate coverage, but planned to begin them and concurred with the recommendations, GAO said.
There is no estimate in the report of how many people have duplicate coverage; GAO says the number is “limited” because a relatively small proportion of people transitioned between Medicaid and exchange coverage, but that the number could grow.
GAO also found that the federal government could be paying the wrong share of a Medicaid enrollee’s costs. The federal government pays 100 percent of the cost under ObamaCare’s Medicaid expansion, but a smaller share under the traditional core of the program. GAO found that there could be mixups between the two categories leading to the wrong share of federal payments.