The Centers for Medicare & Medicaid Services Did Not Identify and Report Potential Antideficiency Act Violations for 12 Contracts Used To Establish the Federal Marketplace Under the Affordable Care Act

A 2008 HHS review of its acquisition process concluded that HHS components, including the Centers for Medicare & Medicaid Services (CMS), did not always obligate and expend funds in compliance with Federal requirements. As a result, in July 2011, HHS reported a department-wide Antideficiency Act violation totaling more than $1.4 billion. These previously identified deficiencies, combined with issues with the October 2013 launch of the Federal marketplace, raised concerns about CMS's management and oversight of contracts awarded in whole or in part for the support of the Federal marketplace. CMS relies extensively on contractors to operate many of its healthcare programs, including the Federal marketplace.