CMS needs to improve its processes for reporting certain pieces of financial management information related to Patient Protection and Affordable Care Act implementation, according to a Government Accountability Office report. Here are five things to know about the GAO's investigation and findings:
1. At the request of House Republicans, the GAO examined the financial and staff resources CMS' Center for Consumer Information and Insurance Oversight expected to use through fiscal year 2014 to enact the private health insurance and health insurance exchange provisions of the PPACA. The GAO obtained the requested information and compared it to supporting documentation that was available, in addition to interviewing CMS officials and reviewing related policies and procedures.
2. The GAO was able to verify the reliability of CMS' $3.7 billion estimate for total FY 2014 obligations, 347 reported staff members as of Sept. 20, 2013, and $79.8 million in total salary expenditures from March 2010 through FY 2013.
3. However, the GAO couldn't determine the reliability of other pieces of financial information because the CMS core financial system didn't provide totals. For instance, the system didn't produce totals for CCIIO-related public relations activities, such as advertising. Information on staff reassignment from CMS and other HHS divisions to the CCIIO also wasn't readily available, according to the report.
4. Various issues led to CMS' inability to provide complete, independently verifiable information on CCIIO staffing and spending in a timely manner, according to the GAO. The agency doesn't have an effective way to identify CCIIO-related information and doesn't have documented procedures for handling non-routine information requests. Additionally, CMS doesn't have documented procedures to make sure requests are reviewed for accuracy. "Because CMS's processes are inconsistent with certain federal accounting and internal control standards, Congress and other decision makers may not have access to timely and reliable CCIIO-related information that they may need to make resource allocation decisions and assessments of program performance," the report states.
5. HHS didn't agree with the GAO's conclusions and recommendations that CMS find options to facilitate the reporting of independently verifiable CCIIO financial management information in a timely manner, in addition to creating policies and procedures for responding to non-routine information requests. HHS believes existing CMS procedures are adequate, according to the report.