When Healthcare.gov launched in October 2013, laden with flaws and mishaps, it raised a number of concerns--namely, did the Centers for Medicare & Medicaid Services (CMS) plan appropriately for the marketplace's launch? A recent Office of Inspector General (OIG) report said, in a word, "No."
The report confirmed the suspicions of lawmakers who questioned the selection of certain contractors for Healthcare.gov, FierceHealthPayer previously reported.
To further investigate the design and development of Healthcare.gov, OIG conducted a review of manuals, regulations and documentation provided by CMS for the 60 contracts associated with the federal marketplace. Former Health and Human Services Secretary Kathleen Sebelius first called for an OIG review of Healthcare.gov in December 2013. Listed below are key findings by OIG as well as recommendations for CMS.
CMS did not prepare for the federal marketplace contracts, according to the report. CMS, in accordance with the Department of Health and Human Services Acquisition Regulation (HHSAR) requirements, was supposed to develop a written acquisition strategy that details how major technology projects will play out. The strategy's intention is to identify and then mitigate certain risks. CMS did not develop any such strategy.
Seven of the contracts required acquisition plans. These serve as a guide for major decisions regarding how the contractor will be chosen and selected. Only five of these contracts had acquisition plans in their files, OIG found. What's more, these plans did not address the necessary information, such as risks, constraints and market research, and four of the five plans were missing the required signatures from CMS officials.
Because an acquisition strategy is required under HHSAR, CMS should make sure that such strategies are completed for all major IT systems. This way, CMS can ensure it selects highly skilled IT contractors.
The OIG also recommended CMS to take advantage of the contract file organization policy, implemented in October 2013, to make sure all contract files are complete and actions are fully supported. In turn, CMS needs to identify that all contracts are accurate and have the necessary signatures.
- here's the report (.pdf)