White House sought safeguards to reduce ObamaCare fraud

The White House is calling for a “more aggressive strategy” to reduce improper payments made by Medicare and the Affordable Care Act (ACA), according to a letter made public to the Department of Health and Human Services (HHS).

{mosads}The Center for Public Integrity obtained the February letter — written by Office of Management and Budget Director Shaun Donovan and addressed to HHS Secretary Sylvia Mathews Burwell — after a Freedom of Information Act lawsuit.

In the letter, Donovan directs HHS to develop plans to reduce improper payments made by Medicare and the ACA.

“While some progress has been made on this front, we believe a more aggressive strategy can be implemented to reduce the levels of improper payments we are currently seeing,” Donovan wrote.

He directed HHS to develop a “comprehensive corrective action plan” to reduce improper payments, which include payments to fraudulent providers or other payments Medicare pays out in the wrong amount or to the wrong person.

He called for a separate focus on improper ObamaCare payments, asking for “a more detailed plan regarding [HHS’s] efforts to improve ACA Marketplace program integrity.”

Donovan asked for the plan on Medicare payments by April 30, 2015 and the ACA plan by May 31, 2015.

HHS said on Thursday that it submitted plans to meet both of these deadlines. 

“HHS and OMB are continuously working together to identify and reduce improper payments,” HHS Spokesman Ben Wakana said in an email.

Donovan points out in the letter that improper payments in traditional Medicare, Parts A and B, increased last year.

Medicare improper payments have long been a problem. There were around $45 billion in improper payments in traditional Medicare in 2014, according to the Government Accountability Office (GAO), or about 13 percent of payments made by the program.

There is less firm data on improper payments under ObamaCare. However, the issue of fraud under the law came into the spotlight in July with the release of a GAO report finding 11 fictitious applicants created by the GAO were able to enroll and keep their ACA coverage. 

– Updated at 9:23 p.m.