tci Medicare Compliance & Reimbursement - 2015 Issue 22

Industry Note: Even Obamacare is at Risk of Fraud

You’ve heard about Medicare fraud and even vulnerabilities in Medicaid and Tricare — but who knew that Obamacare was at risk of compliance issues? That’s the word from an Oct. 23 Government Accountability Office (GAO) report entitled Preliminary Results of Undercover Testing of the Federal Marketplace and Selected State Marketplaces for Coverage Year 2015. As part of the GAO investigation, 10 undercover government representatives attempted to enroll in various insurance plans through the Patient Protection and Affordable Care Act (PPACA) portal using either fake Social Security numbers, duplicate enrollment information or other snags that should have prevented...

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