CMS
NEWS
FOR
IMMEDIATE RELEASE
Contact: CMS Media Relations
September
15,
2014
(202) 690-6145 or press@cms.hhs.gov
CMS update on
consumers who have data matching issues
Of 966,000 individuals with
citizenship or immigration data matching issues as of May 30th,
851,000 are now closed or in progress, a reduction of 88 percent
Of 1.2 million households with
income data matching issues as of May 30th, 897,000 households are
now closed or in progress; consumers will be getting letters this week asking
for information
The
Centers for Medicare & Medicaid Services (CMS) is committed to assisting
consumers and protecting taxpayers by helping to ensure those who are enrolled
in Marketplace coverage meet the eligibility requirements. As CMS prepares for
the next Marketplace open enrollment period beginning on November 15, it is
resolving data matching issues that occurred during the first year so that its
records are accurate before the renewal process begins, and so that consumers
have the information they need about their coverage. Throughout this process
CMS has worked to maintain coverage for those who have sought it in the
Marketplace, while meeting its obligation to the taxpayer to spend its dollars
wisely.
Today,
the Federal Health Insurance Marketplace (Federal Marketplace) began sending
notices to consumers who have an income-related data matching issue.
Individuals who do not respond to numerous previous attempts to contact them by
September 30, 2014 may see the costs of their coverage change. For instance,
this may impact the cost of their monthly premium, deductibles, copays, and
co-insurance, and even their tax bill or refund during filing season.
“The
Affordable Care Act is working for millions of Americans who are able to access
quality health coverage at a price they can afford. In fact, most individuals
who selected a plan with tax credit in the Federal Marketplace are paying less
than $100 a month in premiums,” said CMS Administrator Marilyn Tavenner. “We
are committed to keeping coverage affordable for the millions of Americans who
depend on it, and to doing so in an efficient, transparent way that protects
taxpayers. It’s critically important that consumers who still owe
income-related documents to the Marketplace send them in by September 30 so we
can continue to hold down their costs. We are pleased that the number of
individuals who were at risk of losing their Marketplace coverage, or seeing
changes in their costs because of data matching issues has been dramatically
reduced in the last three months.”
Consumers
often have more up-to-date information than what’s in CMS data sources. For
example, the Marketplace verified income by checking 2012 tax return
information, but a consumer could have switched jobs since those returns were
filed. Just because CMS is double-checking data and requesting more
documentation, doesn’t mean that a consumer has provided false information or
that he or she is ineligible for help paying for coverage or health services –
it simply means that the information on their application doesn’t match what’s
in trusted data sources and therefore has to be verified.
On
May 30, there were roughly 1.2 million households with income-related
data-matching issues. This represents about 1.6 million people. We’ve made
significant progress since then based on an extensive outreach campaign and
enhanced operational effectiveness. As of September 14, approximately 467,000
household income data-matching issues have been closed and an additional
430,000 are currently in the process of being resolved. There are still about
279,000 households with unresolved income-related data-matching issues that
haven’t sent in supporting information, representing 363,000 individuals. CMS
will send letters starting today to individuals who, if they do not send in
supporting documents by September 30, may see their costs change.
Income-related
data matching notices are being sent in English and Spanish and will provide
straightforward instructions on how consumers should submit the necessary
information to the Marketplace to help keep their costs down. Those individuals
receiving a letter referencing September 30 should log into their HealthCare.gov account and select their current application to
upload their documents. They can also mail their information to our consumer
center. To facilitate timely processing, consumers mailing in a copy of their
documents should include the bar code page from the notice with their
documents. Consumers may also contact our call center at 1-800-318-2596 to see
what documents they need to submit and check whether the Federal Marketplace
has received their information.
A
network of partners, local assistors and other stakeholders including community
health centers are actively communicating and engaging consumers to help them
keep their health insurance and eligibility for financial assistance. Consumers
may contact one of our partners in their community to get one-on-one help. To
find one of these local partners, visit Find Local Help on HealthCare.gov.
Today,
CMS is also providing an update on individuals with citizenship and immigration
data matching issues. In August, we sent letters to about 310,000 Federal
Marketplace consumers who had not submitted any outstanding citizenship or
immigration documents after numerous requests. We’ve made progress in
resolving these cases. We received hundreds of thousands of documents in
response to the September 5th deadline resulting in a decrease from
966,000 as of the end of May to 115,000 as of September 14. To date, 115,000
individuals with citizenship and immigration data matching issues have not
responded to our numerous contacts and will be receiving notices saying their
last day of Federal Marketplace coverage is September 30, 2014. Those who
submit information that confirms their eligibility after the deadline may be
eligible for a special enrollment period to enroll in coverage.
For
more helpful tips and the steps these consumers need to take, visit https://www.healthcare.gov/blog
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