Report Cites CMS for Poor Oversight of Health Plan Comparison Portal

CMS does not adequately oversee the "Plan Finder" website that the agency established to help consumers identify suitable individual and small group health plans based on insurer-reported pricing and benefits, according to a report released Tuesday by the HHS Office of Inspector General, Modern Healthcare reports (Block, Modern Healthcare, 4/2).

Background

The Affordable Care Act called for the creation of the plan finder portal as a precursor to the ACA's health insurance exchanges, which are scheduled to open for enrollment later this year.

The comparison tool was launched in 2010. As of last month, it included data from about 8,000 private insurance plans.

According to the OIG report, CMS in fiscal year 2012 spent an estimated $17.2 million to manage and operate the website (Norman, CQ HealthBeat, 4/2).

Details of Report

For its report, OIG examined data on a sample of 98 small group plans and 94 individual plans that are included on the Plan Finder portal (Modern Healthcare, 4/2). The report found that most private insurers reported data as required for use on the site. However, OIG found that CMS:

• Failed to follow up with the few plans that did not submit detailed pricing and benefit information;
• Failed to identify all the insurers who are required under the ACA to submit basic company and product information;
• Did not require insurers to certify that the data they submitted were complete;
• Did not certify that all plans and products were available for sale and recognized by insurers; and
• Did not remove certain inconsistencies in the data that could potentially confuse users (CQ HealthBeat, 4/2).

OIG recommended that CMS:

• Implement procedures to identify insurers that do not submit the required data;
• Require certification of the provided data from an insurer's CEO or CFO; and
• Establish new strategies to ensure that the data are accurate and that plans listed on the site are available for purchase by consumers.

CMS Response

Acting CMS Administrator Marilyn Tavenner -- in a letter accompanying the OIG report -- said that the agency agrees with several of the findings but suggested that the report might "overstate" some issues with the Plan Finder.

Tavenner said that CMS contacts insurers when errors are reported and that officials are making changes to ensure the process runs more efficiently (CQ HealthBeat, 4/2). She added that the "regulations and standards currently under review and proposed for 2014 will help simplify the process, and increase the reliability of information" (Modern Healthcare, 4/2).