Health Insurance Marketplaces Not Required to Verify Claims

Health Insurance Marketplaces Not Required to Verify Claims

Due to legislative and operational barriers, they can rely on self-reported information

WEDNESDAY, July 10 (HealthDay News) -- Health insurance marketplaces will not be required to verify consumers' income and health insurance status and can rely on self-reported information, the Obama administration announced Friday.

Noting that the health law has a requirement that new insurance marketplaces verify consumers' income and health insurance status, a new rule suggests consumers' self-reported information will be used until 2015 when stronger verification systems will be implemented.

After encountering legislative and operational barriers, the federal government will not require those states that are running their own marketplaces to verify consumers' statements regarding enrolment in eligible employer-sponsored plans. States' responsibilities to verify income levels have also been scaled back. Serious penalties, up to $25,000, accompany lying on exchange forms.

"As crunch time is coming, they're just muddling through and figuring out short cuts," Ian Spatz, J.D., a senior adviser at Manatt Health Solutions, told the Washington Post. "It might not be elegant, but this is how they're trying to make the law work."

More Information (https://s3.amazonaws.com/public-inspection.federalregister.gov/2013-16271.pdf )