ObamaCare developers turn to payment tracking

More than three months after ObamaCare’s launch, the Centers for Medicare and Medicaid Services (CMS) is developing a system to track enrollees who have made premium payments.

The CMS would be able to track premium payments through the “834 form” generated on the back end of the system and transmitted from HealthCare.gov to the insurers when someone selects a plan online.

A CMS official told The Hill some issuers were already providing these “effectuated 834 transaction forms,” which will eventually be “the mechanism for making payment and reporting enrollment data as part of our automated system.”

“We anticipate this reporting of effectuated 834 transaction forms to increase over time as CMS’s automated functionality comes online,” the official said.

The official told The Hill that the agency already receives data from issuers informing them of those enrollees that qualified for federal aid under their health plan but have yet to make their first payment.

In its “tech surge” effort, the Obama administration focused on fixing the consumer-facing side of HealthCare.gov and stemming the tide of criticism that engulfed the White House after its botched rollout last fall.

In November, CMS Deputy Chief Information Officer Henry Chao told lawmakers that 30 percent of HealthCare.gov was still under construction, but the specifics remained murky.

The premium payments processing system appears to be a continuation of that back-end buildout.

“Our efforts last fall were laser focused on improving the overall online consumer experience,” CMS spokeswoman Julie Bataille wrote in a blog post last month. “As we enter the next phase of our work, our tech team remains vigilant in our focus — continuing to make improvements that will enhance the consumer experience — but now prioritizing functionality for HealthCare.gov that was less immediately needed for consumers to apply and enroll in coverage in the early days of open enrollment.”

On Wednesday, the Health and Human Services (HHS) Department announced that 3.3 million people have enrolled in ObamaCare.

However, the administration has been criticized because those enrollment figures include people who have selected a plan, but have not necessarily completed the process by making their first premium payment.

According to a CNN survey released last month, 20 percent of enrollees had yet to pay their first month’s premium.

HHS has said it does not have that data because consumers pay the insurers directly. The new system should provide the government the communication line it needs to report those figures.

Critics warn that the enrollment figures, which were already lower than expected because of website problems, could still be inflated, as consumers, particularly the young, select a plan but fail to pay for it.

“The biggest risk now is people thinking that, by picking a plan, that they’re insured, when, in fact, final step is paying the premium,” Larry Levitt, a senior vice president with the Kaiser Family Foundation, told The Hill last month. “I haven’t seen good numbers on how many people are paying premiums, so that to me is the uncertainty.”

Tags Healthcare reform in the United States Patient Protection and Affordable Care Act

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