Several lawmakers and critics are calling out the Office of Personnel Management, which oversees health insurance for 8 million federal workers, for fraud. This comes as there is constant proof that public officials are tinning a multi-billion dollar health scam with taxpayers’ money. According to a Government Accountability Office report, it may be more frequent than many realize.
For example, a Department of Transportation employee fraudulently enrolled his sister and niece on his federal health benefits plan. He registered them as his wife and stepchild. Therefore, they had health insurance for twelve long years on taxpayers’ funds.
Another example is an equipment repair worker at an Army facility in Alabama who kept an ex-wife covered for 14 years. They did not catch him until he tried to add his new wife to the scheme. Moreover, this is not limited to physical workers only.
At the Department of Justice, an employee adds a friend and the friend’s four kids to the insurance scheme. She claimed that they were her family members. Surprisingly, it seems really easy for people to carry out these scams.
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The examples mentioned above are just a few of what federal officials know about. They also believe that thousands of health insurance enrollment scams cost the federal government up to $3 billion yearly.
Therefore, they are calling on the OPM to do something about this problematic situation. Their oversights and failure to properly vet people cost taxpayers billions and raise premiums for millions of civil servants. However, OPM may seem quite passive on this matter.
While they claim they do not have the funding to address the issue, the officials say otherwise. Senator Rick Scott (R-Fla.) believes it is totally unacceptable. Therefore, he plans to introduce a bill in March to require OPM to audit its members.
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“OPM does not care about fraud, or they would do it. It’s not that hard,” said Scott, who requested the Government Accountability Office report.
“Companies do it all the time, and states do it all the time. It’s real simple to put a program in place to do it, so if you don’t do it, that means you support fraud.” However, OPM’s spokesperson responded that they prioritize addressing ineligibility. They told POLITICO that the agency “takes the integrity of the [Federal Employees Health Benefits] Program very seriously and is working diligently with agencies to address improper enrollments within the constraints of our resources from Congress.”
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Seto Bagdoyan, a director of GAO’s’ forensic audits and investigative service team who authored the 2022 report, disagrees with this take. He believes that OPM claims to prioritize the issue, but “they certainly don’t act like it.” Therefore, he agrees with Scott and believes congressional action might be the only way to force OPM to address the issue.
“With what we found to be OPM’s’ passivity in its oversight role, we essentially concluded that program integrity and managing risk are not apparent priorities for OPM,” Bagdoyan said. Scott is positive the bill will pass easily when he puts it into the house. “Unless they were going to go campaign that they like fraud, I can’t imagine anybody would be against it,” he said.
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