CMS faulted on oversight of health plan website

The CMS has failed to exercise appropriate oversight over a website that is designed to help consumers find a health plan in their state, according to HHS' inspector general's office.

“Gaps exist” in ensuring that private insurers comply with reporting requirements, the inspector general's office said in a report issued today on the Plan Finder posted at HealthCare.gov (PDF). The site is intended to help consumers looking for help navigating the Patient Protection and Affordable Care Act.

The CMS did not appropriately follow up with insurers that failed to report detailed pricing and benefit information, did not identify insurers required to submit basic information, and did not ask insurers to certify the data was complete.

The inspector general's office looked at a sample of 98 small group plans and 94 individual plans. Some data found on the website did not match information that was provided from carriers' customer service representatives, and some of the plans listed on the site were not available for sale and even not recognized by insurer customer service reps.

The report recommended that the CMS establish procedures to identify insurers that don't submit the required data; require that each carrier's CEO or CFO certify the data; and implement new strategies to ensure the data is accurate and the plans on the site are in fact on the market.

The CMS generally agreed with the conclusions. “We believe that regulations and standards currently under review and proposed for 2014 will help simplify the process, and increase the reliability of information,” acting CMS Administrator Marilyn Tavenner wrote in a letter responding to a draft of the report.