CMS gives early numbers on health file errors - Politico

The agency in charge of HealthCare.gov estimates that errors affect 10 percent of the enrollee files that it is supposed to send to insurers to confirm coverage.

CMS spokeswoman Julie Bataille said Friday that the current error rate marks a substantial improvement over the site’s performance in October, when as many as one in four of these 834 files contained incorrect information, included duplicate forms or were mistakenly never sent.

The agency, which for weeks has ducked questions about the extent of the problems despite ongoing complaints from insurers, did not provide a total number of how many enrollment files may be involved.

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“It has been difficult for us to categorize and quantify the number of errors,” Bataille said. She could not provide a breakdown for which types of mistakes were more common than others.

A comprehensive review is under way and the data released Friday are “very preliminary,” Bataille said. The agency, which is working to verify the information with insurers, hopes to issue a more detailed report by the end of next week.

The agency’s efforts to identify and correct problems with 834 files are critical if insurers are to have the right information for people who succeeded in navigating through HealthCare.gov and selecting a health plan. HealthCare.gov itself cannot enroll consumers in plans. Once a person has finished signing up, the website must send a file of detailed information about the enrollee to the chosen insurer so that the company can put the person in its system and bill for the premium.

Karen Ignagni, president and CEO of America’s Health Insurance Plans, said Friday afternoon that progress was evident. “The new process put in place this week is making a difference,” she said. “The enrollment files are getting better, but there is more work to do to ensure consumers are covered.”

But since coverage won’t take effect until the first premium is paid, Bataille stressed that people who have questions about their coverage should reach out directly to insurers.

The news comes at the end of the first week of HealthCare.gov’s turnaround following the Obama administration’s self-imposed Nov. 30 deadline for making the site work smoothly.

About 3.7 million people visited the site from midnight Sunday through Friday afternoon and it remained stable throughout, Bataille said. About 29,000 people enrolled Sunday and Monday alone, POLITICO has reported, more than the number that enrolled in the entire month of October.

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CMS provided no update on enrollment figures Friday.

But the improved consumer experience, while a key step forward, masks ongoing problems with the “back end” of the system, especially the 834 files and other unfinished pieces of information technology needed so insurers and the government can check enrollment files against one another and the government can pay subsidies to insurers.

The administration’s tech team is developing a “rigorous monitoring system and feedback loop so that we can be less reliant on anecdotal information” about the 834 issues, Bataille said.

The site will undergo maintenance from 1 a.m. to 5 a.m. on Saturday and Sunday, as it has on recent weekends. During those times, the application and enrollment sections of the site may be down.