The Patient Protection and Affordable Care Act navigator and assister programs put consumers at risk for fraud and identity theft, according to a House Oversight and Government Reform Committee report.
The navigators and in-person assisters perform informational services for Americans who need assistance in shopping for and enrolling in plans through the reform law's health insurance exchanges. The difference between the two programs is navigator programs must be funded as part of the state exchange operations, although planning and start-up costs can be financed through federal grants. Assister programs can be funded entirely through federal exchange grants for the first year of exchange operations.
HHS officials briefed the House committee members on the navigator and assister programs in November, and the information obtained from their testimony and internal HHS documents "call into question the effectiveness of these outreach programs, and, more importantly, the administration's ability to safeguard consumer information," lawmakers wrote in the report.
Issues with the programs include "lax oversight" that fails to ensure organizations report navigator misconduct and the fact that navigators weren't required to undergo background checks, according to the report. The lawmakers wrote navigators from the Urban League of Dallas, for instance, were caught encouraging applicants to lie on their applications to qualify for tax subsidies to help cover premiums. Although CMS put the organization on a "corrective action plan," the report says federal officials had to learn about the incident through news reports rather than internal oversight procedures.
For months, the navigator program has been a target of scrutiny and criticism from Republican lawmakers and state officials. Earlier this year, the oversight committee released a similar report, which concluded the navigator and assister programs lacked basic safeguards against fraud and abuse. Republican members of the House Committee on Energy and Commerce have also questioned HHS officials about the navigator program, asking about the payment of navigator staff, budget evaluations, the use of door-to-door enrollment tactics and other aspects of the effort to help consumers purchase coverage through the new health insurance exchanges.
More Articles on PPACA Navigators:
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Republican Report Raises PPACA Navigator Identity Theft Concerns
HHS Criticizes Florida Officials for Barring Navigators From Health Units