The CMS shows a lack of financial accountability and poor recordkeeping regarding federal healthcare law-related expenditures, according to a report from the Government Accountability Office (PDF).
The CMS will spend $3.7 billion implementing the insurance provisions of the federal healthcare law this year, with roughly 35% of that money allocated to grants for states establishing their own exchanges, the report notes.
But the nonpartisan congressional oversight organization was unable to independently verify the reliability of financial information provided by the CMS about insurance-related expenditures because of shortcomings in the agency's recordkeeping. In addition, GAO was unable to determine how much money was spent on polling, focus groups and other public relations activities. It also was unable to identify how many employees were loaned out to the Center for Consumer Information and Insurance Oversight—the main department overseeing implementation of the insurance provisions—from other offices within the CMS.
“Collectively, these issues increase the risk that significant errors may not be prevented or detected and corrected before information is provided in response to requests from Congress and other decisionmakers,” the GAO report concludes. “Consequently, such users of these data may not have timely and reliable CCIIO-related financial management information, which could hamper their efforts to make informed resource allocation decisions and assessments of program performance.”
In response to the critical report, Republicans accused the Obama administration of purposefully obscuring the costs of the Patient Protection and Affordable Care Act. “After ignoring repeated requests from Congress, we now find out that the administration is not even keeping track of how many taxpayer dollars are going out the door,” said Rep. Dave Camp (R-Mich.), chairman of the House Ways and Means Committee, who requested the GAO report. “Worse yet, the administration won't even account for how much it spent on public relations campaigns promoting their unpopular law.”
At the end of fiscal 2013 there were 347 employees working on the insurance provisions of the federal healthcare law, according to the GAO report. Between 2010 and 2013, the federal government spent $79.8 million on salaries for those workers.
The GAO recommended that the CMS develop a system to respond to requests for detailed financial information in a more timely manner and allow for independent verification.
But the CMS pushed back strongly against the report's conclusions.
“HHS made every effort to comply with information requests, including meeting with GAO throughout the review to explain how data was compiled and providing detailed level support, including numerous tables and detailed transaction reports,” the response from HHS states.
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