GAO report examines Healthcare.gov issues
Since the federal health insurance marketplace launched in October 2013, the government has taken steps to improve the Healthcare.gov website and its functionality. However, a U.S. Government Accountability Office (GAO) report found the Centers for Medicare & Medicaid Services (CMS) needs to do a better job testing and overseeing the website.
The GAO made seven recommendations, including that the Department of Health and Human Services:
- Documents the approval process for functional and technical design requirements documentation.
- Ensures that the CMS business owner, the CMS approval authority and the contractor organization approving authority have a shared understanding of all business, functional and technical requirements for systems supporting Healthcare.gov prior to developing them.
- Documents and approves systems testing policies and procedures.
- Requires key information in system test plans, as recommended by best practices, including the means by which the quality of testing processes will be assured, and the identification of responsibilities for individuals or groups carrying out testing.
- Requires and ensures key information is included in test cases, as recommended by best practices, such as all outputs and exact values; test case dependencies; inputs required to execute each test case; and information about whether each test item has passed or failed testing.
- Ensures schedules for the Healthcare.gov effort are well constructed.
- Develops and implements policy and procedures for estimating level of effort to ensure effort is estimated at the appropriate level (requirements or program area), and define how levels of effort will be used to monitor system development progress.
In its report, GAO said that HHS agreed with these recommendations and would implement them. The authors wrote that HHS plans on instituting a process to ensure functional and technical requirements are approved, developing and implementing a unified standard set of approved system testing documents and policies and providing oversight for Healthcare.gov and its support systems through the department’s investment review board.
“If the department ensures that these and other actions it identified are effectively implemented, then CMS should be better positioned to more effectively manage current and future systems development efforts for Healthcare.gov and its supporting systems,” they wrote.