Two private sector websites have been blocked by federal regulators from accessing consumer information through the federal Obamacare marketplace due to “anomalous activity.”
This unprecedented action is in response to the Centers for Medicare & Medicaid Services facing a surge in unauthorized enrollment and plan switching by rogue agents, with over 200,000 complaints in the first half of the year.
CMS has suspended Benefitalign and Inshura while investigating the anomalous activity to ensure compliance with data standards. These websites, used by insurance brokers to enroll clients in ACA plans, are also mentioned in an ongoing civil lawsuit.
Legislation has been introduced to increase penalties for rogue agents, as complaints from victims have prompted investigations by the GAO and the Office of Inspector General at the Department of Health and Human Services.
The increasing complexity of curbing unauthorized actions while ensuring legitimate enrollments is a challenge the Biden administration faces amid record-breaking ACA enrollments.
Private sector enrollment sites were initially allowed to integrate with healthcare.gov data during the Trump administration. Despite the challenges, CMS has taken actions to address unscrupulous agents and ensure consumer data protection.
The lawsuit alleges misleading advertising and unauthorized changes to ACA policies by these websites, with allegations of sending consumer data to marketers overseas, a claim that the companies dispute.
The lawsuit has added more allegations, expanding on the initial claims of unauthorized switches in ACA plans, leading to financial and access issues for affected consumers.
Attorneys representing victims are seeking class-action status and alleging violations of the RICO Act against the companies involved in these unauthorized enrollment schemes.