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Sen. Wyden puts the heat on CMS
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In response to the explosion of unauthorized ACA plan switching and plan enrollment in by rogue agents in the 32 states using the federal exchange (HealthCare.gov), CMS has vowed not only to step up enforcement but to “add new technological protections to prevent such unauthorized activities from occurring.”
The core “technological” problem is pretty simple, as explained by KFF’s Julie Appleby in her story breaking the news of the escalating fraud. To enter an enrollee’s account and make any changes, such as switching her from one plan to another, an agent registered with HealthCare.gov needs only the enrollee’s name, date of birth, and state of enrollment. As Appleby pointed out, the sixteen state-based marketplaces (SBMs) that license agents (MA and RI don’t) “require more information before the account can be accessed” — usually some form of two-factor authorization — and don’t appear to be suffering from large-scale unauthorized broker activity.
CMS is not moving fast enough for Senator Ron Wyman, who this week sent a letter to CMS administrator Chiquita Brooks-LaSure expressing “outrage with reports that agents are submitting plan changes and enrollments in the Federal marketplace without the consent of the people who rely on these plans” and admonishing, “CMS must do more and you must do it now.”