Comer Presses for Information on Billions Lost to Waste, Fraud, and Abuse in Federal Health Benefits Program - United States House Committee on Oversight and Accountability

Sends letter to OPM requesting information related to program riddled with ineligible participants

WASHINGTON – After a recent report from the U.S. Government Accountability Office (GAO) revealed that the Federal Employees Health Benefits program (FEHB) could be spending up to $1 billion per year on ineligible members, House Committee on Oversight and Accountability Chairman James Comer (R-Ky.) today called on the U.S. Office of Personnel Management (OPM) to provide documents and communications and a staff-level briefing on the matter.

“The Committee on Oversight and Accountability is conducting oversight of the Office of Personnel Management’s (OPM) failure to prevent waste, fraud and abuse in the Federal Employees Health Benefits program (FEHB). On January 9, 2023, the U.S. Government Accountability Office (GAO) revealed that FEHB is riddled with ineligible ‘participants’ who are receiving benefits under the program. GAO estimates that ‘the program may be spending up to $1 billion per year on payments for ineligible members.’ This is a flagrant waste of funds and may be driving up premium costs for eligible participants,” wrote Chairman Comer.

According to GAO, OPM has been aware of this problem for years but failed to address it, leaving the FEHB program riddled with ineligible participants and vulnerable to waste, fraud, and abuse.

“GAO’s report suggests OPM has been aware of this problem for years but has consistently failed to address it effectively. […] To this day, according to GAO, ‘OPM does not plan to establish a monitoring mechanism to identify and remove ineligible family members who already have FEHB coverage.’ Making matters worse, GAO determined OPM’s annual fraud risk assessment of the FEHB program fails to cover ‘fraud risks associated with ineligible members in the program,” Chairman Comer continued. The letter to the Honorable Kiran Ahuja, director of U.S. Office of Personnel Management can be found here.