The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) is heavily focused on federal and state health insurance marketplaces this year. The OIG Health Reform Oversight Plan, released Feb. 24, included 5 to 10 additional OIG reviews of Affordable Care Act components for fiscal year (FY) 2015. This is in addition to the reviews previously outlined in the OIG’s FY 2015 work plan. Specifically, the OIG plans to evaluate the Medicaid expansion and the Pioneer Accountable Care Organization (ACO) Model, and identify potential vulnerabilities within marketplace payment systems. The OIG has already started to review federal financial assistance programs, such as premium tax credits and cost-sharing reduction payments, for accuracy of payments. All planned reviews will take between 9 and 18 months to complete.
Contact Beth Feldpush, DrPH, senior vice president of policy and advocacy, at email@example.com or 202.585.0111 with questions.