On November 18, 2014, the HHS OIG released its annual list of the top 10 management and performance challenges faced by HHS and the OIG during the current fiscal year, and the new and emerging issues that the OIG anticipates will be faced in the coming year. Among other challenges, the OIG identified issues with implementing, operating, and overseeing the health insurance marketplaces, which it considered to be “significant challenges” that would continue to present top management and performance challenges in 2015.
In particular, new and ongoing challenges related to the health insurance marketplaces include ensuring accurate eligibility determinations; processing enrollments, re-enrollments and qualifying life change events; and communicating timely and accurate information to health insurance issuers and consumers. Effective communication and coordination with internal and external parties with marketplace responsibilities will be of paramount importance, as will be effective coordination with, and the timely provision of data to, the Internal Revenue Service for the administration of the premium tax credit program.
Other issues making the OIG’s list for 2014 include ensuring appropriate use of prescription drugs in Medicare and Medicaid; protecting Medicaid from fraud, waste, and abuse in light of its expansion under ACA; and fighting waste and fraud in Medicare Parts A and B, and promoting value in those programs.
For a copy of the OIG’s full list for 2014, please click here.