Over the past few months, we have reported several times that Congress is particularly interested in how the Department of Health and Human Services (HHS), the Office of the Inspector General (OIG) for HHS, and the Centers for Medicare and Medicaid Services (CMS) are using funds to implement programs and systems, particularly those that root out fraud, waste and abuse.
An article back in April of this year expressed doubt over whether the money being spent by CMS was worth its return. Specifically, a computer system designed to prevent fraud had only returned approximately $8,000—only one bad claim.
Pushing for more transparency about how money is spent to implement programs not related to the Medicare and Medicaid programs, as a result of assignments that have been made to CMS through the Affordable Care Act (ACA), the Ways & Means Committee of the U.S. House of Representatives requires that the Government Accountability Office’s (GAO) Financial Management and Assurance (FMA) team review such expenditures.
In a letter sent to GAO, the Committee explained how the Obama Admistration chose to move the Center for Consumer Information and Insurance Oversight (CCIIO), the agency in charge of implementing much of the ACA, into a business unit within CMS. As was expected, Democrats “vastly understated” the extent of funding necessary to implement the law, as a result, leading to spending of CMS dollars that may be inappropriate.
One news outlet reported that “By embedding the CCIIO within CMS, the administration should have greater ease finding funds within CMS to enable CCIIO to operate as part of the HHS secretary’s office.”
In order to better understand the magnitude of money and resources being taken from the Medicare program, the Committee requested GAO’s FMA to conduct a complete full financial analysis, including financial and forensic audits, of CMS activity since the ACA was signed into law. They asked for specifics about CMS’ financial and staff resources regarding the CCIIO. The information is due to the committee by October 15, 2012.
It will be interesting to see just exactly how much money is being spent on the CCIIO, particularly in light of the fact that CMS has recently delayed several important pieces of the ACA, most notably, the Physician Payment Sunshine Act. Moreover, if Obama is reelected, will the Administration continue its current structure and use of CMS funds to operate the CCIIO?
The revelation that healthcare reform is taking more resources and staff than expected is no surprise. According to a study from Georgetown University’s Center on Education and Workforce issued last month, the nation needs 5.6 million new jobs by 2020 to meet the growing demand for care under health reform.