CMS oversight of health plan website subpar

The Centers for Medicare & Medicaid Services has done a poor job overseeing its "Plan Finder" website, created to aid consumers in their search for appropriate medical coverage, according to a report unveiled this week by the U.S. Department of Health & Human Services' Office of Inspector General. The site was developed after the Affordable Care Act was signed into law in 2010.

While the agency has "implemented numerous strategies to monitor data accuracy," OIG found that data on the site posted by private insurers contained "inconsistencies." For instance, products and plans promoted on the site were not always available to consumers. For products that were available and recognized by payer representatives, 81 percent of information displayed on the site matched information provided by those insurance representatives.

Additionally, CMS failed to follow up with insurance companies that failed to report pricing and benefit information to the site; the agency, OIG said, has been unable to determine all of the insurers required to report basic company and product information.

To remedy the situation, OIG called on CMS to:

  • Create measures for identifying private insurers that have not submitted required data to the site
  • Ensure the authenticity of insurance information on the site via confirmation from company executives
  • Develop a plan to better determine the accuracy of information posted to the site
  • Consistently ensure that such information remains accurate (ensuring products and plans listed for sale are actually for sale)

"For American consumers to obtain the maximum benefit from the Plan Finder, the private health insurance data displayed there must be complete and accurate," OIG said.

CMS Acting Administrator Marilyn Tavenner, in response to the report, said that she agreed with most of OIG's recommendations, although she added that the report "overstates the problems … by underappreciating the degree to which the current insurance market operates in non-standard ways."

Last summer, CMS, in an announcement in the Federal Register, said it was looking to improve the usability of the site for consumers. It planned to test a "quick links" homepage to cut down on steps users would need to take to access plan information, as well as "enhanced data display" to make information posted by the insurance companies appear less overwhelming.

A loophole in the ACA that enables consumers to renew their current policies for an extra year could allow insurers to avoid covering additional benefits mandated under the law for an additional year. Currently, only 2 percent of insurers offer all of the reform-mandated benefits.

To learn more:
- here's the OIG report (.pdf)


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