ACA Application Process Still Vulnerable to Fraudulent Documents
November 20, 2015
The post on Slashdot titled Affordable Care Act Exchanges Fail to Detect Counterfeit Documentation relates the ongoing issue of document verification within the Affordable Care Act (ACA) process. The Government Accountability Office) GAO submitted fake applications to test the controls at the state and federal level for application and enrollment in the ACA. The article states,
“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…”
The GAO report itself mentions that eight of the ten fakes were failed at first, but later accepted. It shows that among the various ways that the fake applications were fraudulent included not only “impossible” Social Security Numbers, but also duplicate enrollments, and lack of employer-sponsored coverage. Ultimately, the report concludes that the ACA is still “vulnerable.” Granted, this is why the GOA conducted the audit of the system, to catch issues. The article provides no details on what new controls and fixes are being implemented.
Chelsea Kerwin, November 20, 2015
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