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Fraud is going unchecked, says US agency

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i1211 (Published 29 February 2016) Cite this as: BMJ 2016;352:i1211
  1. Michael McCarthy
  1. Seattle

Officials administering the federal health insurance exchange created by the Affordable Care Act are not taking the steps needed to stop fraud, said the US Government Accountability Office, an investigative agency of the US Congress. The Centers for Medicare and Medicaid Services (CMS) “assumed a passive approach to identifying and preventing fraud,” the report said.

The exchange, Healthcare.gov, provided a marketplace where users could compare private health insurance and apply for income based subsidies to help cover the cost of premiums. It was administered by the CMS, which …

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