Possible Civil and Criminal Offenses During ACA Implementation?

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The transition to a new healthcare exchange in Massachusetts has gone poorly. In a forthcoming report, Pioneer Institute will examine what exactly went wrong during implementation, with the help of two whistle-blowers and internal audits on the project.

Yet during the research for that project, Pioneer uncovered multiple incidents of state officials misleading and possibly lying to federal officials in order to keep federal funds.

Given the appearance of both civil and criminal offenses, Pioneer Institute viewed it as necessary to send a letter to the director of the FBI, the Chairman of the Committee on Oversight and Government Reform, the HHS Inspector General, and the managing director for information technology at GAO detailing two of these incidents. These agencies (and the committee) have already opened investigations in other states that have mismanaged a state-based exchange, but not in Massachusetts to date.

The first incident in the Commonwealth pertains to significant misrepresentations of the state’s progress in project development in a May 2013 presentation to federal government officials.

The second involves using open source software for a test, instead of the software being developed, and hiding the fact that the back end of the site did not exist. The FBI has an active investigation for very similar allegations in the state of Oregon.