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Affordable Care Act Exchanges Fail To Detect Counterfeit Documentation (atr.org)
Tulsa_Time writes with this excerpt of an account from the (unapologetically partisan) Americans for Tax Reform about a report released by the Government Accountability Office in which "application and enrollment controls on the federal exchange and two state exchanges (California and Kentucky)" were investigated by supplying false information; in each case, the investigators were able to obtain and activate health insurance through the exchanges. A slice:
Ten fictitious applicants were created to test whether verification steps including validating an applicant's Social Security number, verifying citizenship, and verifying household income were completed properly. In order to test these controls, GAO's test applications provided fraudulent documentation: "For each of the 10 undercover applications where we obtained qualified health-plan coverage, the respective marketplace directed that our applicants submit supplementary documentation we provided counterfeit follow-up documentation, such as fictitious Social Security cards with impossible Social Security numbers, for all 10 undercover applications."
I'm sure submitting false information on those forms is illegal.
Why should it be illegal? If you want to buy insurance for someone that doesn't exist, that is fine with me.
This is the typical charge for obtaining gov't assistance under many different false pretenses, but typically under-reporting income.
I, for one, would prefer to keep the trust but verify nature of the programs... the aim is not to catch fraudsters straight away, but to help folks when they need it. Sure, some will game the system, but likely not for an extended period before getting caught with the hand in the cookie jar.
Happiness in intelligent people is the rarest thing I know.
Ernest Hemingway
You want to arrest the GAO for fraud, for doing their actual job?
That's who wrote the report. Americans for Tax Reform just reported on it.
Why should it be illegal? If you want to buy insurance for someone that doesn't exist, that is fine with me.
How about if in the course of applying, the fake person also describes a lifestyle that qualifies them for completely subsidized care that other people get to go to work every day to buy for them? This is no different than any other of benefit fraud.
Don't disappoint your bird dog. Go to the range.
I'm sure submitting false information on those forms is illegal.
Why should it be illegal? If you want to buy insurance for someone that doesn't exist, that is fine with me.
But are you ok with them submitting and getting paid for claims for that fictitious person? Buying insurance for a fictitious person should be as illegal as submitting claims for them, so if you find that someone has bought 1000 policies for fictitious people, you have a tool to stop them before they start submitting claims.
I, for one, would prefer to keep the trust but verify nature of the programs
I would if there was any "verify". There was not.
People claim the U.S. should emulate Europe, but it seems they go mysteriously silent when it comes to emulating the controls that Europe has to make healthier care voting work to prevent fraud. If a system has endemic fraud it will eventually fail.
"There is more worth loving than we have strength to love." - Brian Jay Stanley
Single payer. Book it done.
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How about if in the course of applying, the fake person also describes a lifestyle that qualifies them for completely subsidized care that other people get to go to work every day to buy for them? This is no different than any other of benefit fraud
Well, it is different, an insurance is just paper (contract), when you obtain the contract to benefit a person that doesn't exist, you've acted in bad faith and obtained a contract that is invalid by nature.
:)
So your chances of successfully upholding the contract is slim. That said, yesm the fake people could probably get some care, before the private insurance company starts looking at the details... This is another problem with private insurance, if there is a problem with contract the insurance company will declare it invalid (but they won't do so before you file a claim, ie. only when do it when you the insurance).
But yes, this is great
Note. insurance contracts in the US are in my experience, super sketchy have through my employer and had to fight very hard to get any kind of actual paper... and I'm still not satisfied that I have sufficiently strong contract to sue my insurance provider should it come to that, and certainly not if my employer decided not to look out for my interest (which I don't have contract saying they will). So legally speaking I'm is a poor standing (despite working for tech company, and having an good PPO plan).
Forget about illegal. The system couldn't even figure out that the details were completely invalid and fictitious. It's unable to do the slightest bit of basic sanity checking.
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