Blame rollout on CMS, GAO says


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The part of the Department of Health & Human Services tasked with planning the IT development of did so without enough planning or oversight, according to a new report from the Government Accountability Office.

HHS’ Centers for Medicare & Medicaid Services were given the responsibility of developing and implementing the information technology systems for the marketplace portion of the Patient Protection and Affordable Care Act, popularly known as Obamacare, which was signed into law in 2010.

More than $800 million later, and after the troubled rollout of the online marketplace on as well as the struggles that some state exchanges faced, GAO conducted a study finding that CMS and the project’s main contractor CGI Federal were responsible for some of the problems associated with the rollout.

“We found that CMS undertook the development of and its related systems without effective planning or oversight practices, despite facing a number of challenges that increased both the level of risk and the need for effective oversight,” William Woods, director of GAO’s acquisition and sourcing management department, said in his written testimony for a congressional hearing Thursday.

The report was released the day before Woods’ testimony before the House Energy & Commerce Committee for a hearing on ACA implementation. The committee also heard testimony from Andy Slavitt, the principal deputy administrator for CMS.

Slavitt joined the CMS three weeks before the hearing, and prior to that his only involvement was as a contractor in October as the department tried to turn the marketplace difficulties around.

Before joining CMS, Slavitt was the executive vice president at Optum, a private sector company that works to improve health care.

During Woods’ testimony, however, he said that CMS could have known more about some of the problems the website would face if it hadn’t delayed reviews of the system.

“Moreover, CMS delayed key governance reviews, moving an assessment of FFM (federally-funded marketplace) readiness from March to September 2013 – just weeks before the launch – and CMS did not receive required governance approvals,” Woods said. “As a result, CMS launched without verification that it met performance requirements”

Despite the rocky beginnings for the marketplace, Slavitt said in his written testimony that CMS expects the second year of open enrollment and the second year of the FFM to go more smoothly.

“This coming year will be one of continued improvement, but not perfection,” Slavitt said in his written testimony. “We still have a lot to learn that will help us continue to improve the marketplace. We are in the first year of a program newly serving millions of consumers, many with unique and complex needs and many of whom are gaining coverage for the first time.”

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Andy Slavitt, Centers for Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), Health apps, Health data, Health IT, Tech, William Woods