CMS Update on Consumers who have Data Matching Issues

Did you sign up for insurance through the Affordable Care Act? If so, you might be in for an unpleasant surprise. The Internal Revenue Service announced it is using tax returns to verify the incomes people claimed when they signed up for exchange-based health insurance. If you didn’t input the right amount, you may owe the government some money.

The Federal Health Insurance Marketplace (Federal Marketplace) began sending notices to consumers on September 15 who have an income-related data matching issue. Individuals who do not respond to previous attempts to contact them by September 30, 2014 may see the costs of their coverage change and/or be faced with fines. 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.

You may 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 you could have switched jobs since those returns were filed. So, although the CMS is double-checking data and requesting more documentation, this doesn’t mean that you have provided false information or that you are ineligible for help paying for coverage or health services – it simply means that the information on the application doesn’t match what’s in their data sources and therefore has to be verified.

Special thanks to David Enquist of our Moses Lake office for this post.

Paul Neiffer, CPA