Most Federal HIX Inconsistencies Went Unresolved

A new report from the Department of Health and Human Services Office of the Inspector General, officially released Wednesday but dated June 2014, finds that on the state-based marketplaces, consistency results varied while in the federal marketplaces, 2.6 million of 2.9 million, or 89%, of inconsistencies went unresolved. The field research on which the report is based was conducted between October and December 2013.

Get access to this article and thousands more...

All Health Data Management articles are archived after 7 days. REGISTER NOW for unlimited access to all recently archived articles, as well as thousands of searchable stories. Registered Members also gain access to exclusive industry white paper downloads, web seminars, podcasts, e-books, and conference discounts. Qualified members may also choose to receive our free monthly magazine and any of our e-newsletters covering the latest breaking news, opinions from industry leaders, developing trends and specialized topics like EHR's, revenue cycle management, health insurance exchanges, analytics, and more!

Already Registered?

Forgot Password/Need Help?
Comments (2)
The article states 2.6M to 2.9M inconsistencies. The commenter Kash claims these numbers are "way exaggerated" and are actually 2.2M. "Way exaggerated?" Hardly! That's a helluva lot of "inconsistencies." Anything more than 10-15% is way out of the ordinary. And misstating income as 50k when it's 100k is a HUGE inconsistency that will result in erroneous subsidies.
And don't forget that these "inconsistencies" on the exchange side need to be reconciled with the QHP side. So yes, this is a huge problem. I know several people who are living with this reconciliation and trying to sort out the mess created by bad software and process on the intake side.

It's a huge issue. I'll believe what these people relate long before I believe what the government or any vendor that's involved with this on the government side claims.
Posted by Steven S | Wednesday, July 02 2014 at 8:36PM ET
First off the numbers are way exaggerated. There are around 2.2 million inconsistencies. Inconsistencies occur for example when a consumer states they make 50K and the IRS reports they make 100K. Im not saying many consumers lie, but lets face it, people lie when its to their benefit. This discrepancy is one type of inconsistency.

CMS has worked incredibly hard to work through the inconsistency backlog. In addition they have built a number of really great tools to help the call center reps resolve these inconsistencies in a very complex environment.

Ping me if you want more detail, we help deal with these issues on the ground.
Posted by Kash B | Wednesday, July 02 2014 at 2:22PM ET
Add Your Comments:
Not Registered?
You must be registered to post a comment. Click here to register.
Already registered? Log in here
Please note you must now log in with your email address and password.


Slide Shows

Already a subscriber? Log in here
Please note you must now log in with your email address and password.