Overnight Healthcare: Spotlight falls on ObamaCare fraud

by Peter Sullivan - 07/20/15 6:16 PM ET

A watchdog report on fictitious people signing up for ObamaCare has put renewed attention on the potential for fraud and abuse in the system.

Congressional Republicans, who have long warned about a lack of safeguards in ObamaCare, pounced on Wednesday as the nonpartisan Government Accountability Office (GAO) released the results of an investigation that found 11 of 12 fabricated people were able to enroll in coverage through the federal marketplace.

Experts say that in starting up the marketplace, which is less than two years old, the Obama administration and its Centers for Medicare and Medicaid Services (CMS) had to prioritize getting people in the door over fighting fraud.

{mosads}”There’s been more of a push to get people enrolled and then kind of catch up with the validation and integrity piece of it,” said Louis Saccoccio, CEO of the National Health Care Anti-Fraud Association, a public-private partnership.

“The GAO found some real issues, but this is a young program that will shore up its processes over time,” said Michael Adelberg, who formerly helped oversee the marketplace as a senior CMS official and now is a consultant at FaegreBD.

In addition, Sen. Orrin Hatch (R-Utah) on Monday asked for an inspector general investigation of the around 710,000 ObamaCare subsidy recipients who have not filed tax returns. Hatch says some of these people could be committing fraud. Read more here.

PLANNED PARENTHOOD HITTING BACK: Planned Parenthood said Monday that it’s been hit by at least 10 illegal attacks from the same anti-abortion activists that released last week’s video.

The organization’s chief legal counsel Roger Evans told House Republicans in a letter that the anti-abortion activist group has illegally taped staff or patients at least 65 times over the last decade.

Evans said the secretly filmed video – which generated more than 2 million views online – was created by anti-abortion activists who have repeatedly broken laws to gain access to Planned Parenthood as part of a “decade-long pattern of illegal harassment.”

His letter was in response to one of two House GOP-led investigations into the organization after the video surfaced last week, depicting a top Planned Parenthood official describing fetal tissue donations. Read more here.

WALKER SIGNS LATE-TERM ABORTION BAN: Gov. Scott Walker (R) on Monday became the fifteenth governor to ban nearly all abortions after 20 weeks.

The GOP presidential candidate signed the bill as Congress is considering its own version of the legislation. The House has passed the bill, and the Senate is looking to mark up the measure in September, galvanized in part by a new viral video of comments by a Planned Parenthood executive on abortion.

Walker said Monday that his state’s measure is a “reasonable standard” and will survive court challenge. Read more here.

Tuesday’s schedule

Sens. Dick Durbin (D-Ill.) and Susan Collins (R-Maine) will speak as part of Atlantic LIVE’s Alzheimer’s: The Cost of Caring conference.

Reps. Judy Chu (D-Calif.) and Brett Guthrie (R-Ky.) will join HHS officials for a briefing on addressing viral hepatitis disparities.

State by state

About 1,200 Medicaid recipients to transition to Connecticut health exchange

Tribes push to end Affordable Care Act coverage requirement

Florida insurers claim they’re underpaid by state

What we’re reading

The Children’s Health Insurance Program is dying

Sketchy claims for high-tech health fraud buster

Families on Medicaid make incorrect assumptions about antibiotics